monitoring antipsychotic drug treatment

Question 1

if a patient is on clopazine, they must be registered with

Answer 1

clozapine patient monitoring service

Question 2

when prescribing an antipsychotic drug for admin in emergency siutation (e.g. for rapid tranquilisation), how often do you need to monitor pt

Answer 2

monitor for SE and vital signs at least every hour until no further concerns about physical health status
monitor every 15 mins if high dose antipsychotic has been given

Question 3

pt with schizophrenia should have physical health monitoring (including cardiovascular disease risk assessment) ….

Answer 3

atleast annually

Question 4

monitoring for olanzapine

Answer 4

• blood lipids and weight: baseline, at three months (measure weight at freq intervals during first 3 months), every 3 months for first year, then yearly
• FBG at baseline, after one months, then every 4-6 months

Question 5

treatment cessation for all antipsychotic drugs

Answer 5

high risk of relapse if medication is stopped after 1–2 years
Withdrawal of antipsychotic drugs after long-term therapy should always be gradual and closely monitored to avoid the risk of acute withdrawal syndromes or rapid relapse
Patients should be monitored for 2 years after withdrawal of antipsychotic medication for signs and symptoms of relapse

Question 6

there is high risk of relapse if antipsychotic drug is stopped after. ..

Answer 6

1-2 yrs

Question 7

patients should be monitored for …. after withdrawal of antipsychotic meds for signs and symptoms of relapse

Answer 7

2 yrs

Question 8

why should patients be advised to avoid direct sunlight with all antipsychotics

Answer 8

because photosensitisation can occur with higher dosages

Question 9

it is advisable to monitor prolactin conc …

Answer 9

start of therapy, at 6 months, then yearly

Question 10

when to monitor prolactin conc in pt who are not normally associated with symptomatic hyperprolactinaemia

Answer 10

should be considered for prolactin monitoring if they show symptoms of hyperprolactinaemia (such as breast enlargement and galactorrhoea)

Question 11

do you need to monitor BP with amisulpride or aripiprazole

Answer 11

does not affect blood pressure to the same extent as other antipsychotic drugs and so blood pressure monitoring is not mandatory for this drug

Question 12

monitoring of weight with antipsychotics

Answer 12

Weight should be measured at the start of therapy with antipsychotic drugs, then weekly for the first 6 weeks, then at 12 weeks, at 1 year, and then yearly.

Question 13

FBG, HBA1C, blood lipid conc monitoring with antipsychotics

Answer 13

should be measured at baseline, at 12 weeks, at 1 year, and then yearly.

Question 14

before initating antipsychotic drugs, an ECG may be required, esp if …

Answer 14

physical examination identifies cardiovascular risk factors (e.g. high blood pressure), if there is a personal history of cardiovascular disease, or if the patient is being admitted as an inpatient.

Question 15

Blood pressure monitoring for antipsychotics

Answer 15

advised before starting therapy, at 12 weeks, at 1 year and then yearly during treatment and dose titration of antipsychotic drugs.

Question 16

expert sources advise to monitor full blood count, urea and electrolytes, and liver function tests ….

Answer 16

at the start of therapy with antipsychotic drugs, and then yearly thereafter.

Question 17

in children, regular clinical monitoring of endocrine function should be considered when children are taking an antipsychotic known to increase prolactin levels - this includes monitoring

Answer 17

• weight and height
• assessing sexual maturation
• monitoring menstrual function