Since the introduction of so called second generation antipsychotic (SGA), the prescription of these drugs has been relatively frequent in adolescence. This article gives a synopsis of the potential side effects and contra-indications, and proposes a practical guideline for the follow-up of these SGAs in adolescent and young adults. The main secondary side effects are in metabolic, endocrine, neurologic, cardiovascular systems and also on the hematological and liver functions. Thus, a strict follow-up should start before the introduction of a SGA treatment and should be continued during the time of administration. Since there is no common consent for a follow-up in SGA use in adolescents for Europe, this article may give a practical guideline for general practitioners and pediatricians, including a clinical exam and biological parameters to be controlled.