Ask the doctor: What tests monitor the metabolic risks of antipsychotics?
Q. My daughter has schizophrenia. The psychiatrist at her mental health center prescribed an antipsychotic. I know some of these drugs increase risk of diabetes and heart disease. What sort of clinical monitoring do you advise?
A. Your question is well timed; it arrived shortly after the Archives of General Psychiatry published a study reporting that fewer than one-third of Medicaid patients being treated with second-generation antipsychotics were being monitored for early signs of diabetes or heart disease.
Many second-generation antipsychotics — particularly clozapine (Clozaril) and olanzapine (Zyprexa) — cause weight gain, increase risk of type 2 diabetes, and create unhealthy cholesterol levels that can increase risk of heart disease. These risks are collectively referred to as metabolic risks. Adding to the challenge, there is some research evidence that schizophrenia on its own may increase risk of type 2 diabetes and heart disease.