Antipsychotic medications are regarded as indispensable in the treatment of psychiatric disorders; however, their administration has been associated with metabolic and hormonal adverse effects. In the present case–control study, the influence of such medications on lipid metabolism, glucose homeostasis, and hormonal balance was examined in 80 patients with chronic psychiatric disorders (schizophrenia, bipolar disorder, and drug-induced psychosis) and compared with 15 healthy controls recruited at Alhawary Psychiatric Hospital, Benghazi, Libya. Biochemical assessments included fasting blood sugar (FBS), glycated hemoglobin (HbA1c), lipid profile (cholesterol, triglycerides, HDL, LDL), prolactin, thyroid-stimulating hormone (TSH), serum albumin, C-reactive protein (CRP), and creatine kinase (CK). No statistically significant differences were observed in FBS, HbA1c, or lipid parameters (p > 0.05). Conversely, significant elevations in prolactin (20.22 vs. 8.8 ng/mL, p = 0.000), CRP (p = 0.033), and CK (p < 0.05), together with a reduction in serum albumin (p = 0.001), were detected among patients. These findings suggest that antipsychotics exert pronounced effects on hormonal and inflammatory pathways, most likely mediated through dopaminergic and mitochondrial mechanisms, while exerting limited influence on lipid and glucose profiles in this cohort. It is therefore recommended that prolactin, CRP, and CK be routinely monitored to mitigate long-term risks. Further research is warranted to clarify underlying mechanisms and to optimize therapeutic strategies.......................... Keywords:...............Antipsychotics, lipid metabolism, glucose homeostasis, prolactin, psychiatric disorders, metabolic side effects.