Schizophrenia (free trial)

Assessment 2 Table 1. Suggested Physical and Laboratory Assessments for Patients with Schizophrenia (continued) Assessment Initial or Baseline Follow-Up Assessments related to possible side effects of treatment (continued) Triglycerides Assess monthly for the first 3 months Assess annually once treatment is stabilized or more frequently for high risk patients Suspected congenital QTc prolongation (family history of fainting or sudden death) ECG and serum potassium before treatment with thioridazine or pimozide. ECG before treatment with ziprasidone, chlorpromazine or iloperidone in the presence of cardiac risk factors or concomitant QT-prolonging medications ECG with signifcant change in dose of thioridazine, pimozide, and, in the presence of cardiac risk factors, ziprasidone, iloperidone, or addition of other medications that can affect QTc interval. Annually for other patients Hyperprolactinemia Screening for symptoms of hyperprolactinemia Screening for symptoms of hyperprolactinemia at each visit until stable, then yearly if treated with an antipsychotic known to increase prolactin Prolactin level, if indicated on the basis of clinical history Prolactin level, if indicated on the basis of clinical history Extrapyramidal side effects, including akathisia Clinical assessment of extrapyramidal side effects (dystonia and Parkinsonism) Clinical assessment of extrapyramidal side effects weekly during acute treatment until antipsychotic dose is stable for at least 2 weeks, then at each clinical visit during stable phase Tardive dyskinesia Clinical assessment of abnormal involuntary movements (AIMS or similar scale) Clinical assessment of abnormal involuntary movements every 6 months in patients taking conventional antipsychotics and every 12 months in those taking atypical antipsychotics In patients at increased risk, assessment should be done every 3 months with treatment using conventional antipsychotics and every 6 months with treatment using atypical antipsychotics Cataracts Clinical history to assess for changes in distance vision or blurred vision Annual clinical history to assess for visual changes; ocular examination with visual acuity, cataract screening and glaucoma screening recommended every 2 years for patients under age 40 and every year for patients over age 40 erapeutic drug monitoring Clinical assessment of drug serum levels to ensure they are within therapeutic range Re-evaluation of serum drug levels, especially in cases where optimal drug efficacy is not obtained or medications known to alter levels are added

• Cover
• Key Points
• Assessment
• Treatment
• Abbreviations and Sources
• Figure 1. Antipsychotic Algorithm
• Commonly Used Medications
• Choice of Medication in Acute Phase
• Receptor Binding Profiles