29th January 2024

Investigations

Prior to initiating treatment with antipsychotics, a thorough physical health assessment must be conducted. This includes:

• Baseline bloods (FBC, U+E, LFT, CRP), including lipids and HBA1C (due to increased risk of metabolic syndrome with antipsychotic use), Thyroid Function Test (risk of hypothyroidism), Prolactin (risk of hyperprolactinaemia), and Vit B12, Folate and Ferritin (patients may present in malnourished states)
• ECG: Certain antipsychotics (e.g. Haloperidol) have a higher propensity for prolonging QTc interval or may induce ECG changes, thus obtaining a baseline to compare is essential
• Pregnancy test: certain antipsychotics are teratogenic
• Height, Weight, BMI: Patients taking antipsychotics have increased risk of metabolic syndrome
• General physical examination
• Vital Signs: This is of particular importance when patients are newly commenced on antipsychotics that have a high risk of neuroleptic malignant syndrome (e.g. Haloperidol, Chlorpromazine)
• Urinalysis, including drug screening: can help in ruling out other causes of disordered behaviour, e.g. UTI, cocaine