Antipsychotics, like all medications, are associated with adverse effects. Clinicians should adhere to conscious monitoring of these adverse effects to ensure their safe use. Experts have formulated recommended monitoring parameters to assist with prevention, early detection, and management of potential adverse effects.

  • What are some general rules to follow when prescribing antipsychotics?1-2
  • Which vitals, labs, and screenings should be ordered for patients receiving antipsychotics and how frequently?3-6
  • Can pharmacists assist with metabolic monitoring for patients receiving antipsychotics?7
  • How does a clinician manage comorbid metabolic syndrome disorders in patients with mental illness?8-12

References

  1. American Psychiatric Association. Five things physicians and patients should question. 2013. [Weblink]
  2. Adams KS. Toolbox: Metabolic adverse effects of atypical antipsychotics. Ment Health Clin. 2013;3(3):115-8. [Weblink]
  3. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry. 2004;65(2):267-72. [PubMed]
  4. Hasnain M, Vieweg WVR, Frederickson SK, et al. Clinical monitoring and management of the metabolic syndrome in patients receiving atypical antipsychotic medications. Prim Care Diabetes. 2009;3(1):5-15. [PubMed]
  5. Khasawhneh FT, Shankar GS. Minimizing cardiovascular adverse effects of atypical antipsychotic drugs in patients with schizophrenia. Cardiol Res Pract. 2014;2014:273060. [PubMed]
  6. Saklad SR. Monitoring for antipsychotic metabolic effects in an inpatient setting. Ment Health Clin. 2011;1(1):10-12. [Weblink]
  7. Azfr Ali RS, Jalal Z, Paudyal V. Guidelines versus practice in screening and monitoring of cardiometabolic risks in patients taking antipsychotic medications: where do we stand? Gen Psychiatr. 2021;34(4):e100561. [PubMed]
  8. American Psychiatric Association. The American Psychiatric Association Practice Guideline for the Treatment of Patients with Schizophrenia. Table 2, Statement 1. 2020. [Weblink]
  9. Bermudes RA, Keck PE, McElroy SL. Managing metabolic abnormalities in the psychiatrically ill: A clinical guide for psychiatrists. American Psychiatric Publishing. 2007. [Weblink]
  10. Dayabandara M, Hanwella R, Ratnatunga S, et al. Antipsychotic-associated weight gain: management strategies and impact on treatment adherence. Neuropsychiatr Dis Treat. 2017;13:2231-41. [PubMed]
  11. Saldaña SN and Kawsky J. Monitoring and treatment of weight gain in children and adolescents treated with second generation antipsychotics (SGAs). Men Health Clin. 2011;1(1):3-5. [Weblink]
  12. Cooper SJ, Reynolds GP, Barnes T, et al. BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. J Psychopharmacol. 2016;30(8):717-48. [PubMed]
25 Years!