Antipsychotic Medication Monitoring

As of 10/1/02, all patients on antipsychotics will be required to have the following parameters monitored as part of the Alameda County BHCS Practice Guidelines1:

WeightBaseline, q visit x 9 months, then q 3 months
Glucose Baseline, 6 months, then q year
Cholesterol/Triglycerides Baseline, 6 months, then q year
Prolactin* Baseline, 6 months, then q year
EKG** Baseline & periodic**

* Risperidone and all conventional agents

** thioridazine, ziprasidone: Only in patients at risk for QTc polongation. Periodic monitoring dependent on changes in electrolyte status (hypokalemia or hypomagnesemia) as a result of diuretic therapy, diarrhea, etc.

These drugs are contraindicated in patients with a known history of QT prolongation (including congenital long QT syndrome), with recent acute myocardial infarction, with uncompensated heart failure or with a history /family history of syncope or sudden cardiac death. These agents should not be used with any drug that prolongs the QT interval, and should be discontinued in patients who are found to have a QTc interval over 500 milliseconds.

1   Marder, Essock, Kane, Lieberman, Schooler et al. The Mt. Sinai Conference on the Pharmacotherapy of Schizophrenia. Schizophrenia Bulletin V28:1, 2002. Pgs 5-16.