7
Suggested physical and laboratory assessments for
patients with schizophrenia
Assessment Initial or baseline
a
Follow-up
b
Assessments related to other specific side effects of treatment
Diabetes
f
Screening for diabetes
risk factors,
g
fasting
blood glucose
h
Fasting blood glucose or
hemoglobin A1C at 4 months after
initiating a new treatment and at
least annually thereafter
h
Hyperlipidemia
Lipid panel
i
Lipid panel
i
at 4 months after
initiating a new antipsychotic
medication and at least annually
thereafter
Metabolic syndrome Determine whether
metabolic syndrome
criteria are met
j
Determine whether metabolic
syndrome criteria are met
j
at 4
months after initiating a new
antipsychotic medication and at
least annually thereafter
j
QTc prolongation ECG before treatment
with chlorpromazine,
droperidol, iloperidone,
pimozide, thioridazine,
or ziprasidone
k
or in
the presence of cardiac
risk factors
l
ECG with significant change
in dose of chlorpromazine,
droperidol, iloperidone, pimozide,
thioridazine, or ziprasidone,
k
or with the addition of other
medications that can affect QTc
interval in patients with cardiac
risk factors
l
or elevated baseline
QTc intervals
Hyperprolactinemia Screening for
symptoms of
hyperprolactinemia
m
Prolactin level, if
indicated on the basis
of clinical history
Screening for symptoms of
hyperprolactinemia at each visit
until stable, then yearly if treated
with an antipsychotic known to
increase prolactin
m
Prolactin level, if indicated on the
basis of clinical history
Antipsychotic-
induced movement
disorders
Clinical assessment
of akathisia, dystonia,
parkinsonism, and
other abnormal
involuntary
movements, including
tardive dyskinesia
n
Assessment with a
structured instrument
(e.g., AIMS, DISCUS) if
such movements are
present
Clinical assessment of akathisia,
dystonia, parkinsonism, and
other abnormal involuntary
movements, including tardive
dyskinesia, at each visit
n
Assessment with a structured
instrument (e.g., AIMS, DISCUS)
at a minimum of every 6 months
in patients at high risk of tardive
dyskinesia
o
and at least every 12
months in other patients
p
as well
as if a new onset or exacerbation
of preexisting movements is
detected at any visit
See full text guideline for additional important information in footnotes.
(cont'd)
