Purpose: To evaluate the antipsychotic drugs most commonly prescribed for schizophrenia patients in Peshawar, Pakistan and to analyze the treatment costs associated with these drugs. Methods: One hundred patients diagnosed with schizophrenia were recruited from outpatient psychiatry departments in Peshawar, Pakistan and followed for one year. Demographic data were collected for each patient at the beginning of the study. A questionnaire was used to collect antipsychotic prescription information at 4, 8 and 12 months. The cost of antipsychotics was obtained from PharmaGuide, Pakistan. The cost associated with antipsychotic drug use was statistically analyzed using post hoc tests. Results: Of the patients who completed this study, 68.1 % were prescribed second-generation antipsychotic (SGA) drugs, 6.9 % first-generation antipsychotic (FGA) drugs, and 25.0 % a combination of SGAs and FGAs. Furthermore, 40.3 % of the patients who completed the study received antipsychotic monotherapy and 34.7 % antipsychotic polytherapy. In monotherapy, risperidone was the most commonly prescribed antipsychotic drug, used by 44.8 % of patients while in polytherapy, risperidone plus olanzapine was the most commonly prescribed combination, used by 32 % of patients. Switching of antipsychotic drugs was observed in 25 % of patients. The mean annual cost of antipsychotic therapy was US$79.90 (8079 Pakistani rupees). Risperidone treatment cost was US$60.30 (PakRs 6095), constituting 52 % of the total monotherapy cost. The cost of SGAs was significantly higher than the cost of FGAs (p < 0.05). Conclusion: The results provide policymakers with appropriate information necessary for managing pharmacotherapy plans for the treatment of schizophrenia.