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. 2020 Nov 5;18(4):402–423. doi: 10.1176/appi.focus.20200034

TABLE 1.

Suggested physical and laboratory assessments for patients with schizophreniaa

Assessment Initial or baseline Follow-up
Monitoring physical status or detecting concomitant physical conditions
 Vital signs Pulse, blood pressure Pulse, blood pressure, temperature as clinically indicated
 Body weight and height Body weight, height, and BMI BMI every visit for six months and at least quarterly thereafter
 Hematology CBC, including ANCb CBC, including ANC if clinically indicated (e.g., patients treated with clozapine)
 Blood chemistries Electrolytes, renal function tests, liver function tests, TSHc As clinically indicated
 Pregnancy Pregnancy test for women of childbearing potential
 Toxicology Drug toxicology screen, if clinically indicated Drug toxicology screen, if clinically indicated
 Electrophysiological studies EEG, if indicated on the basis of neurological exam or history
 Imaging Brain imaging (CT or MRI, with MRI preferred), if indicated based on neurological exam or history
 Genetic testing Chromosomal testing, if indicated on the basis of physical exam or history, including developmental history
Monitoring for specific side effects of treatment
 Diabetes Screening for diabetes risk factors, fasting blood glucose Fasting blood glucose or HbA1c four months after initiating a new treatment and at least annually thereafter
 Hyperlipidemia Lipid panel Lipid panel four months after initiating a new antipsychotic medication and at least annually thereafter
 Metabolic syndrome Determine whether metabolic syndrome criteria are met Determine whether metabolic syndrome criteria are met four months after initiating a new antipsychotic medication and at least annually thereafter.
 QTcd prolongation ECG before treatment with chlorpromazine, droperidol, iloperidone, pimozide, thioridazine, or ziprasidone or in the presence of cardiac risk factors ECG with significant change in dose of chlorpromazine, droperidol, iloperidone, pimozide, thioridazine, or ziprasidone or with the addition of other medications that can affect QTc interval among patients with cardiac risk factors or elevated baseline QTc intervals
 Hyperprolactinemia Screening for symptoms of hyperprolactinemia; prolactin level, if indicated on the basis of clinical history Screening for symptoms of hyperprolactinemia at each visit until stable, then yearly if treated with an antipsychotic known to increase prolactin; prolactin level, if indicated on the basis of clinical history
 Antipsychotic-induced movement disorders Clinical assessment of akathisia, dystonia, parkinsonism, and other abnormal involuntary movements, including tardive dyskinesia; Assessment with a structured instrument (e.g. AIMS, DISCUSe) if such movements are present Clinical assessment of akathisia, dystonia, parkinsonism, and other abnormal involuntary movements, including tardive dyskinesia, at each visit. Assessment with a structured instrument (e.g. AIMS, DISCUS) at a minimum of every 6 months in patients at high risk of tardive dyskinesia and at least every 12 months in other patients as well as if a new onset or exacerbation of pre-existing movements is detected at any visit
a

See table 2 of the full practice guideline for additional details.

b

CBC, complete blood count; ANC, absolute neutrophil count.

c

TSH, thyroid stimulating hormone.

d

QTc, corrected QT interval.

e

AIMS, Abnormal Involuntary Movement Scale; DISCUS, Dyskinesia Identification System–Condensed User Scale.