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A 19-year-old man is admitted with a first episode of psychosis after eight weeks of persecutory beliefs and voices. He has never taken an antipsychotic. His body mass index is 33 kg/m2, his mother and grandmother have type 2 diabetes, and his fasting blood glucose is 5.9 mmol/L [3.0-5.4]. He stacks supermarket shelves on night shift and says he cannot afford to be drowsy at work. Electrocardiogram and kidney function are normal, and he will take tablets. Which one of the following is the most appropriate antipsychotic to start?
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