Antipsychotics are drugs used to treat psychiatric disorders. Their discovery in the 1950's led to the mass discharge of patients from psychiatric institutions and their return to society. However, they have also been shown to often cause side effects that reduce patients' quality of life, increase mortality and morbidity, and at the same time cause a significant financial burden for health organisations. This study explains the metabolic group of side effects that are known to occur: weight gain, insulin resistance, dyslipidemia, cardiovascular side effects and metabolic syndrome. The study provides an overview of the pathophysiology, epidemiology, and clinical features of the metabolic side effects of antipsychotics. The ideal antipsychotic is the one that is most effective with the lowest risk of side effects. However, the mechanism of action of antipsychotics is one of the most complex mechanisms in medicine in general. First of all, because their therapeutic place of action is the brain which is a complex structure. Secondly, because they act on many neurotransmitter systems in the brain, mostly by direct effect on the dopamine system, but also on the serotonin, histamine, noradrenergic and cholinergic systems, indirectly on the GABA and glutamate systems, and by using a complex mechanism they also affect the expression of numerous genes. Studies of the association of psychotic disorders and antipsychotics with weight gain, metabolic syndrome, diabetes, dyslipidemia, and elevated blood pressure conclude that there is a need for an active, routine health review of patients on that therapy. The priority should be a rational choice of when and what to prescribe. Of second importance is intervention in terms of lifestyle changes to prevent weight gain. Today, there are various guidelines for monitoring metabolic disorders that improve the quality of patient care and further inform in which direction to implement the intervention strategy. Antipsychotics should only be prescribed if their benefits are clear and there is no safer alternative. The choice of antipsychotics should be based on the patient's clinical situation and the lowest effective dose should be used, which is different for each patient. For those drugs that show side effects, the dose should first be reduced, then replaced with a drug with less severe side effects. Non-pharmacological measures should be suggested such as diet and exercise and lastly, side effects should be treated with concomitant therapy. The role of the pharmacist is essential for recognising and preventing side effects. The main pharmacist's interventions are early recognition, proper counseling of patients about changes in life habits and monitoring of the patient's condition. Patient education and close collaboration with healthcare professionals can reduce mortality and improve patients’ quality of life. In conclusion, metabolic side effects of antipsychotics are a significant clinical problem, but in many cases they could be prevented by education, regular checkups, and appropriate interventions.