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Recommendations

Summary of monitoring

References Schizophrenia and related psychoses CHAPTER 1 recommended by NICE for secondary prevention of cardiovascular events.61 NICE makes no recommendations on target levels for primary prevention but recent advice promotes the use of statins for anyone wit...

Diabetes and impaired glucose tolerance

Schizophrenia

Antipsychotic medications

First-generation antipsychotic medications

Second-generation antipsychotic medications 174 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Diabetes and impaired glucose tolerance Schizophrenia Schizophrenia is associated with relatively high rates of insulin resistance and type 2 diabetes1...

Predicting antipsychotic-related diabetes

Monitoring 176 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 ­glucose homeostasis. Aripiprazole may even reverse diabetes caused by other drugs73 (although ketoacidosis has been reported with aripiprazole).74–76 Further, studies have not found a...

Treatment of antipsychotic-related diabetes

Prescribing high-dose antipsychotic medication Schizophrenia and related psychoses CHAPTER 1 ■ ■The use of high-­dose antipsychotic medication should be an exceptional clinical practice and only ever employed when adequate trials of such medication (including ...

Summary: antipsychotic medications – risk of diabetes and impaired glucose tolerance Schizophrenia and related psychoses CHAPTER 1 Frequency of monitoring should be determined by physical factors (e.g. weight gain) and known risk factors (e.g. family history o...

References 178 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 References Schimmelbusch WH, et al. The positive correlation between insulin resistance and duration of hospitalization in untreated schizophrenia. Br J Psychiatry 1971; 118:429–436. ...

Blood pressure changes with antipsychotics

Orthostatic hypotension 182 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Blood pressure changes with antipsychotics Orthostatic hypotension Orthostatic hypotension (postural hypotension) is one of the most common cardiovascular adverse effects ...

Hypertension Schizophrenia and related psychoses CHAPTER 1 Antipsychotics with a high affinity for postsynaptic α1-­adrenergic receptors are most frequently implicated in postural hypotension. Among the SGAs, the reported incidence is highest with clozapine (2...

References 184 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 dopamine receptor antagonism.9 All five dopamine receptor subtypes (D1–5) are known to be involved in renal sodium excretion and blood pressure regulation.9 Antipsychotics vary in thei...