Initial optimism regarding the introduction of second-generation antipsychotic drugs has decreased because of accumulating concerns regarding efficacy and safety issues, particularly in terms of weight gain and disturbances in glucose and lipid metabolism. These adverse effects, in addition to posing serious health risks, significantly compromise patient compliance and contribute to overall lack of therapy effectiveness. Consequently, research efforts have been directed toward the development of new pharmacological treatment options for schizophrenia and bipolar disorder that are both efficacious and well tolerated. This review discusses some of the most recently developed antipsychotic compounds that have undergone clinical assessment from the perspective of their metabolic impact.