New and emerging treatments for schizophrenia: a narrative review of their pharmacology, efficacy and side effect profile relative to established antipsychotics

•Several new agents reduce psychotic symptoms without direct action on D2 receptors.•Cariprazine, pimavanserin and roluperidone may treat negative symptoms.•Some data suggest roluperidone, xanomeline and BI425809 improve cognitive symptoms.•Partial D2 agonists and low D2 affinity drugs could benefit treatment resistance.•Novel agents have low rates of both extra-pyramidal and metabolic side effects.