What metabolic monitoring is appropriate when patients are taking antipsychotic medication? Are there any labs or vital signs to monitor?

Patients taking antipsychotic medications are a population at increased risk for metabolic problems such as diabetes, hyperlipidemia, hypertension, or obesity. Monitoring depends on the individual patient’s history, preexisting conditions, use of other medications, risk factors and health status. The APA schizophrenia guideline includes recommendations regarding metabolic monitoring. Recommended assessments at initial assessment include: pulse, blood pressure, weight, height, calculation of body mass index, fasting blood glucose or hemoglobin A1C, and lipid panel. Follow-up assessments include pulse and blood pressure at each visit or as clinically indicated. Follow-up assessments at each visit for 6 months and then quarterly include: weight, height, and calculation of body mass index. Follow-up assessments at 4 months after initiating a new treatment and annually thereafter include: fasting blood glucose or hemoglobin A1C, and lipid panel.

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