Atypical antipsychotic drugs have become the treatment of choice for psychotic disorders. However, these medications, though certainly superior in many respects to the more traditional medications, have been shown to have a number of untoward consequences. Understanding of the metabolic consequences of these medications is essential for the psychiatrist. The possible development of diabetes, weight gain, and hypertriglyceridemia in patients taking atypical antipsychotics makes it imperative that the prescribing physician regularly monitor patients on these agents. One possible monitoring scheme is outlined and recommendations for treatment are discussed.