Final answer:
Quetiapine and clozapine are the two second-generation antipsychotics with the lowest risk of causing extrapyramidal side effects (EPS). These medications are chosen for their favorable profiles regarding movement disorders, although other side effects may occur.
Step-by-step explanation:
Second generation antipsychotics, also known as atypical antipsychotics, are a class of medications used for treating psychiatric conditions such as schizophrenia and bipolar disorder. These medications tend to have a lower risk of causing extrapyramidal side effects, which are drug-induced movement disorders that can include symptoms like tremors, rigidity, bradykinesia, and tardive dyskinesia. Among the atypical antipsychotics, quetiapine and clozapine are generally considered to have the lowest risk for EPS. Quetiapine's lower affinity for dopamine receptors, particularly the D2 receptor, accounts for its reduced risk of causing these movement disorders.
Clozapine, on the other hand, has a unique pharmacological profile, with lower dopamine antagonist activity compared to other antipsychotics, which contributes to its minimal EPS risk. It is important to remember that while these medications have a lower EPS risk, they may carry other side effects, including metabolic syndromes and sedation. Clinicians prefer to use these medications, especially for patients who have experienced EPS with other antipsychotics or when managing patients who have a high risk of developing these side effects.