Antipsychotics are associated with adverse effects. Clinicians should adhere to conscious monitoring of the adverse effects related to use with antipsychotics. 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?1-3
  • Which vitals, labs, and screenings should be ordered for patients receiving antipsychotics and how frequently?3-6
  • How can pharmacists assist with metabolic monitoring for patients receiving antipsychotics?67-8
  • How does a clinician manage comorbid metabolic syndrome disorders in patients with mental illness?9-12
  • What are some strategies to effectively monitor for extrapyramidal symptoms (EPS)?3,14

Reviewer 1: Allison Beatty, PharmD
Reviewer 2: Trisha McHugh, PharmD
Reviewer 3: Austin Smith, PharmD, BCPP
2023-2024 AAPP Resident and New Practitioner Committee

References

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  2. Adams KS. Toolbox: Metabolic adverse effects of atypical antipsychotics. Ment Health Clin. 2013;3(3):115-8. [Weblink]
  3. San Francisco Health Network Behavioral Health Services Medication Use Improvement Committee. Safer prescribing of antipsychotic medications guideline. 2021. [Weblink]
  4. American Diabetes Association. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry. 2004;65(2):267-72. [PubMed]
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  9. American Psychiatric Association. The American Psychiatric Association Practice Guideline for the Treatment of Patients with Schizophrenia. Table 2, Statement 1. 2020. [Weblink]
  10. Bermudes RA, Keck PE, McElroy SL. Managing metabolic abnormalities in the psychiatrically ill: A clinical guide for psychiatrists. American Psychiatric Publishing. 2007. [Weblink] (Only book available)
  11. 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]
  12. Saldaña SN, 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]
  13. 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]
  14. Kane, J. Drug-induced movement disorders: a clinical guide to rating scales. [Weblink]