Schizophrenia is a complex neurodevelopmental disorder with deficits in cognition, affect, and social relationships and requires prompt treatment at the first signs of a psychotic episode. Although it rarely occurs in children, the incidence of schizophrenia increases steadily after puberty. Psychotic disorders are typically characterized by positive symptoms (insanity, hallucinations, catatons or motor symptoms, disorganized behavior and flow of thought), as well as negative symptoms (apathy, lack of communication, social distance). When we talk about children and adolescents, it is difficult to determine the existence of true hallucinations in relation to children's games. The younger the child the diagnosis of schizophrenia is more problematic. Adolescence is a very sensitive period and it is more difficult to be affected by psychosis in the middle of adolescent development than when the disease begins in adulthood. Some young patients with schizophrenia have experienced only one episode of the disease, while most of them experience more. Recovery is incomplete in an average of 80 % of cases adolescents had more than one episode of the disease. The prognosis in 50 % of children with schizophrenia is unfavorable and worsens the earlier and gradual onset of the disease, so it is very important in a timely manner recognizing symptoms, making a diagnosis, and starting treatment. Antipsychotics are drugs that are used in the treatment of schizophrenia and act in a way to reduce symptoms of the disease. They are divided into the first generation of antipsychotics (typical) and the second generation of antipsychotics (atypical). The mechanism of action of first-generation antipsychotics is antagonism of D2 dopamine receptors, but also nonselective action on other central and peripheral receptors, while blockade of serotonin 5-HT2A receptors and differences in the mode of action on dopamine D2 receptors are characteristic for the second-generation antipsychotic. Because of differences in the mechanisms of action between the first and second generation antipsychotics, there are also differences in side effects. Extrapyramidal syndrome, dystonic reactions and other motor disorders similar to parkinsonism are characteristic of typical antipsychotics, while atypical antipsychotics mostly causes metabolic, cardiovascular, anticholinergic side effects. The goal of all therapeutic approaches is to control the clinical picture as quickly and as well as possible, with monitoring and control of side effects to allow continuous development and normal the functioning of the child and adolescent in the social and family environment.