Approximately one percent of patients receiving antipsychotic medications develop seizure activity. In addition, approximately seven percent of epileptic patients develop chronic psychosis requiring antipsychotic treatment. A history of antipsychotic-induced seizures in patients exhibiting florid psychosis should not preclude the use of antipsychotic medications. Different antipsychotics affect the seizure threshold in varying degrees, and the least epileptogenic agents should be selected for this population. Predisposing factors and other risk factors associated with antipsychotic-induced seizures are identified. Guidelines for the use of antipsychotic medications in psychotic patients with a history of seizures are presented.