General advice

For advice on monitoring for and preventing antipsychotic adverse effects, see Overview of antipsychotic adverse effects.

Antipsychotics differ in their potential to cause cardiometabolic adverse effects (eg weight gain, dyslipidaemia, hyperglycaemia, hypertension)—see Approximate relative frequency of common adverse effects of antipsychotics for approximate relative frequencies.

If a cardiometabolic adverse effect occurs:

  • educate the patient about healthy eating1 and physical activity2 and encourage them to undertake these interventions long term
  • encourage the patient to stop smoking. Smoking cessation can increase the concentration of some antipsychotics (eg clozapine, olanzapine); consult a drug information resource
  • review and rationalise concurrent drugs that may be contributing to weight gain (eg mirtazapine, sodium valproate), hyperglycaemia (eg glucocorticoids), hypertension (eg serotonin and noradrenaline reuptake inhibitors [SNRIs]) or dyslipidaemia (eg oral estrogens)
  • switch to an antipsychotic less likely to cause cardiometabolic adverse effects, if the above measures are ineffective—see Approximate relative frequency of common adverse effects of antipsychotics for approximate relative frequencies of cardiometabolic effects.
1 For advice on a healthy diet, see Australian Dietary Guidelines.Return
2 For advice on physical activity, see Australia’s Physical Activity and Sedentary Behaviour Guidelines and the Australian 24-Hour Movement Guidelines.Return