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Psychosis: Monitoring guidelines

Table 7.2: Recommended monitoring guidelines

 

 

clinical and laboratory monitoring

monitoring frequency

acute phase

stable phase

Hematology: CBC

baseline

yearly

Blood chemis- try: electrolytes, renal function, liver function, thyroid function

baseline

yearly

Cataracts: func- tional inquiry and ocular exam

baseline

q2 years to age 40, then yearly

Vital signs

baseline

as indicated clinically

ECG

as indicated clinically, and before starting antipsychot- ics with QTc effects

as indicated clinically

Extrapyramidal signs and symp- toms: Parkinson- ism, dystonia, dys- kinesia, akathisia

baseline, when changing antipsychotic dose, then weekly for 2 – 4 weeks

q6 months and as needed

Body mass: BMI, waist circumfer- ence

baseline, then monthly

for 6 months when starting antipsychotic

q3 months

Fasting blood sugar

baseline, and 4 months after starting a new antipsychotic

yearly, or more frequently if symptomatic or gaining weight

Fasting lipid panel

baseline

at least q2 years,

q6 months if LDL elevated

 

clinical and laboratory monitoring

monitoring frequency

acute phase

stable phase

Endocrine and sexual function: functional inquiry and prolactin level where indicated

baseline, monthly for 3 months after starting new antipsychotic

yearly

 

1    Based  on Canadian Psychiatric Association Working Group (2005) and American Psychiatric

Association (2000).