This network meta-analysis compares the efficacy and tolerability of antidopaminergic and muscarinic antipsychotics in the treatment of acute schizophrenia. Analyzes randomized controlled trials indexed in international English and Chinese databases. The study provides evidence of small to moderate clinically relevant differences in efficacy between antipsychotics. These differences require greater and more specific emphasis in clinical guidelines. Important differences in tolerability must be considered when selecting a drug for an individual. Dopamine partial agonists are generally better tolerated. Xanomeline-trospium does not have the side effects of dopamine blockers, but it does cause cholinergic and anticholinergic side effects.