Atypical antipsychotics (AAPs) became an important part of modern psychiatric treatment during the 1990s, and significantly changed the treatment of schizophrenia by offering broader symptom control as well as a more favorable tolerability profile.4 AAPs have also been successfully used in EOS, and the US Food and Drug Administration has approved the use of aripiprazole, olanzapine, risperidone, quetiapine, and paliperidone in adolescents.5 However, the literature on their use in pediatric patients remains limited. There have been few randomized controlled trials (RCTs) in adolescent schizophrenia.6 The aim of our review is to summarize what we understand about the efficacy and safety of AAPs in EOS, with special attention paid to the onset of action of AAPs and the associated weight gain.