General News — 20 October 2012
Psychiatrists not following antipsychotic guidelines

Weekly weight checks and regular waistline measurements should be a routine part of the management of young psychiatric patients starting antipsychotic medication, argue the authors of a recent review.

Although antipsychotic medications are known to increase the risk of weight gain and metabolic syndrome in children and adolescents, psychiatrists are not following guidelines, the authors said.

Consequently, there are low rates of monitoring for metabolic risks in these patients, the authors, including two from the University of New South Wales, wrote in the ANZJP.

The current RANZCP guidelines advocate measurement of weight and BMI at the start of antipsychotic therapy and monthly measurements for the first six months, with quarterly checkups thereafter.

Recent trials had estimated that rates of diabetes and obesity in people with schizophrenia were nearly twice that of healthy people, they said.

The effect of weight gain on young people with a psychotic illness could not only limit their opportunity to do basic physical activities such as walking, but could damage their self-worth and stigmatise them to the point where they decided to discontinue medication for their mental illness, they wrote.

Clarity was needed over who was responsible for monitoring the physical health of the patient with the choice resting between the psychiatrist and the GP, they said.

“Available evidence suggests that we are failing to provide reasonable standards of physical care for young patients with mental illness, and that this is further exaggerated… in patients on antipsychotic medication due to the added metabolic risk.”

As first appeared in Psychiatry Update, 18 October 2012. Source: Australian and New Zealand Journal of Psychiatry, 2012

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