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