Which antipsychotic medication is discouraged as first-line therapy due to severe side effects?

Clozapine is discouraged as first-line therapy primarily due to its association with severe side effects, most notably agranulocytosis, which is a potentially life-threatening decrease in the white blood cell count. This significant risk necessitates regular monitoring of the patient's blood cell counts, making clozapine more appropriate for patients who have treatment-resistant schizophrenia or for those who cannot tolerate other antipsychotics.

In addition to agranulocytosis, clozapine is also associated with other serious side effects, including seizures and myocarditis, which further limits its use as a first-line treatment option. The necessity of stringent monitoring protocols and the potential for severe side effects make clozapine a second-line choice, reserved for specific clinical situations.

While other antipsychotic medications listed have their own side effect profiles, they are generally considered safer and more effective as first-line treatments for schizophrenia, allowing for broader use in the initial management of this condition.