Table 1 — Prior to Initiating Treatment with Second Generation Antipsychotics

• Conduct thorough physical examination
• Screen for:
    o Personal/family history of diabetes
    o Dyslipidemia
    o Hypertension
    o Cardiovascular disease
• Screen for substance abuse disorders
• Screen for pregnancy
• Get baseline measures of:
    o BMI
    o Waist circumference
    o Blood pressure
    o Fasting plasma glucose
    o Fasting lipid profile
• Assess the presence of EPS (akathisia, dystonia, parkinsonism, tardive dyskinesia)


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BMI=body mass index; EPS=extrapyramidal symptomsAvery LM. Int J Psychiatry Med. 2016;51(2):145-59.

Table 2 — Monitoring Patients During Treatment with Second Generation Antipsychotics

• Evaluate BMI at regular intervals
    o 4 weeks
    o 8 weeks
    o 12 weeks
    o Quarterly
• Evaluate waist circumference annually
• Monitor for EPS (akathisia, dystonia, parkinsonism, tardive dyskinesia)
    o Weekly until dose is stable
    o Informally at every visit, and formally using a rating scale (eg, Abnormal Involuntary Movement Scale [AIMS])

BMI=body mass index; EPS=extrapyramidal symptomsAvery LM. Int J Psychiatry Med. 2016;51(2):145-59.