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

Essential Questions and References

What are some general rules to follow when prescribing antipsychotics?

  1. APA: Five things physicians and patients should question. 2013. [Weblink]
  2. Toolbox: Metabolic Adverse Effects of Atypical Antipsychotics. Ment Health Clin. 2013;3(3):115-118. DOI: 10.9740/mhc.n166834.

Which vitals, labs, and screenings should be ordered for patients receiving antipsychotics and how frequently?

  1. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care. 2004;27(2):596-601. [PubMed]
  2. Clinical monitoring and management of the metabolic syndrome in patients receiving atypical antipsychotic medications. Prim Care Diabetes. 2009 Feb; 3(1): 5-15. [Weblink]
  3. Minimizing Cardiovascular Adverse Effects of Atypical Antipsychotic Drugs in Patients with Schizophrenia. Cardiol Res Pract. 2014; Epub 2014 Feb 4. [PubMed]
  4. Monitoring for Antipsychotic Metabolic Effects in an Inpatient Setting. Ment Health Clin. 2011;1(1):10-12. DOI: 10.9740/mhc.n74806.

Can pharmacists assist with metabolic monitoring for patients receiving antipsychotics?

  1. Monthei EM and Kutscher EC. Evaluation of lipid and glucose monitoring after implementation of a pharmacist initiated antipsychotic monitoring form. 2012. [Weblink]

How does a clinician manage comorbid metabolic syndrome disorders in patients with mental illness?

  1. Bermudes RA, Keck PE, McElroy SL.  Managing metabolic abnormalities in the psychiatrically ill: A clinical guide for psychiatrists.  American Psychiatric Publishing 2007. [Weblink]
  2. Dayabandara M, Hanwella R, Ratnatunga S, Seneviratne S, Suraweera C, de Silva VA. Antipsychotic-associated weight gain: management strategies and impact on treatment adherence. NDT. 2017;13:2231-2241. DOI: 10.2147/NDT.S113099. PubMed PMID: 28883731; PubMed Central PMCID: PMC5574691.
  3. Saldaña SN and Kawsky J. Monitoring and treatment of weight gain in children and adolescents treated with second generation antipsychotics (SGAs). Mental Health Clinician. 2011; 1(1): 3-5. [Weblink]
  4. Cooper SJ, Reynolds GP, Barnes TRE, England E, Haddad PM, Heald A, 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. DOI: 10.1177/0269881116645254. PubMed PMID: 27147592.