Physical Health Monitoring of Antipsychotic Medications – Patient Information Leaflet

Antipsychotic medications are used to help manage a number of different problems but they all have similar side effects. Our team will help you to manage any side-effects through regularly monitoring you whilst you are taking antipsychotic medications. This leaflet will explain:
• Why we monitor antipsychotics
• How we monitor antipsychotics
• When you will need to have monitoring

Antipsychotic medications have a number of side-effects including:
– Sleepiness
– Weight gain
– High blood pressure
– High blood sugar levels
– High blood fats (cholesterol/triglycerides)
– Dizziness
– Problems with movement such as shakes, stiffness, slowness
– Sexual problems
– Breast tenderness
– Irregular periods/changes to your periods

You might not always be aware of side-effects if they are slight and you may not associate them with your medication, so it’s important we look for and monitor any side-effects.

Through monitoring we can:
– Pick up and act on side-effects which may cause you problems
– Watch out for changes that may increase your risk of diabetes and heart disease and take action to manage this
– Monitor changes that might make it unsafe to carry on taking antipsychotic medications.

We have a Physical Health Clinic, staff at the clinic will monitor you whilst you are taking antipsychotic medication. They will check:

Blood
We do a range of blood tests which monitor your:
– Liver
– Kidneys
– Cholesterol and fat levels
– Full blood count
– HbA1c – tells us about how well your body manages sugar levels
– Prolactin – a hormone that can go up in the body which causes sexual side effects and changes to your periods.

Weight
We monitor your weight and measure your waist circumference, as weight gain is associated with health problems. We also calculate your BMI.

Heart health
If you have underlying health conditions, it may be recommended that you have an electrocardiogram (ECG).
An ECG tells us about your heart rhythm. We get this by putting stickers over your chest and connecting these to the machine which then detects your heart rate.

Side effect monitoring
We will regularly ask you to complete a questionnaire about possible side effects that you may be experiencing.

When we monitor
Everyone prescribed antipsychotic medication is offered monitoring.

If you are prescribed clozapine, you will need to have additional monitoring on a weekly, fortnightly or monthly basis. You will be informed of this.

If you are prescribed a high dose of antipsychotics, you will require more frequent physical health monitoring. You will be advised about this.

We’ll invite you for appointments at:
– Weekly monitoring for the first six weeks. (The first appointment will be within two weeks of starting your medication) then;
– Three months after starting medication and then
– 12 months after starting medication

After the first year your GP may take over your physical monitoring. You may then only need to be monitored once a year for as long as you are prescribed antipsychotic medication.

Not all checks are necessary at each appointment. These are the checks you can expect and when:

• Blood tests
– Within two weeks of starting medication
– After one month
– Three months (If you are prescribed Olanzapine three month checks take place again at six months and nine months.)
– 12 months
– Yearly

• Blood pressure and heart rate
– Within two weeks of starting medication (may be done regularly while your does is optimised)
– After one month
– Three months (If you are prescribed Olanzapine three month checks take place again at six months and nine months.)
– 12 months
– Yearly

• ECG
– Within two weeks of starting medication
– Three months (If you are prescribed Olanzapine three month checks take place again at six months and nine months.)
– 12 months
– Yearly (if recommended)

• Weight and Body Mass Index (may include waist measurement)(BMI)
– Within two weeks of starting medication
– Weekly for six weeks
– Three months (If you are prescribed Olanzapine three month checks take place again at six months and nine months.)
– 12 months
– Yearly

• Side effects check
– Within two weeks of starting medication
– Weekly for 5 weeks
– Three months (If you are prescribed Olanzapine three month checks take place again at six months and nine months.)
– 12 months
– Yearly

• Lifestyle review
– Within two weeks of starting medication
– Three months (If you are prescribed Olanzapine three month checks take place again at six months and nine months.)
– 12 months
– Yearly

We recommend that you attend the monitoring clinics, but they are not compulsory. Sometimes there is value in remaining on the medications even where we do not have the full monitoring arrangements in place. As you are the decision maker in your care, we will be happy to discuss these arrangements with you.

If you have any queries about your medication please contact:

Pharmacy Medicines Information helpline,

Tel: 0191 245 6604

The helpline is available 9am – 4pm Monday to Friday (excluding public holidays).

A voicemail facility operates at all other times.
 

If you want to make a comment, suggestion, compliment or complaint you can:

• talk to the people directly involved in your care
• ask a member of staff for a feedback form, or complete a form on the Trust website
• telephone the Complaints Department Tel: 0191 245 6672
• email [email protected] Please note that information sent to the Trust via email is sent at your own risk

 
We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention. You can provide feedback in the following ways:

• the quickest way for you to do this is to complete our short online survey at www.cntw.nhs.uk/poy
• complete a Points of You survey, available on wards, reception areas or from staff
• other options for sharing your feedback and experience www.cntw.nhs.uk/yourfeedback

 
Patient Advice and Liaison Service (PALS)
PALS provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care.

We act independently when handling patient and family concerns, liaising with staff, managers and, where appropriate, relevant organisations, to negotiate prompt solutions. If necessary, we can also refer patients and families to specific local or national-based support agencies.

North of Tyne
Tel: 0800 032 0202
Email: [email protected]
Post: FREEPOST PALS

South of Tyne
Tel: 0800 328 4397
Text: 07825 061 035
Email: [email protected]
Post: Patient Advice and Liaison Service, Garden Lodge, Hopewood Park, Ryhope, Sunderland, SR2 0NB

9am – 4.30 pm, Monday to Friday
An answerphone is available at all times for you to leave a message. A member of the PALS team will aim to return your call as soon as possible.

– Prescribers Guide, Stephen M Stahl 5th Edition
– Maudsley Prescribing Guidelines in Psychiatry, 13th Edition, David Taylor, Carol Paton, Shitij Kapur – Wiley Blackwell
– Monitoring requirements for adult patients prescribed antipsychotics (except clozapine) (CNTW PPT-PGN-08)
– Psychosis and schizophrenia in adults: prevention and management Clinical guideline (CG178)

Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think about this leaflet please get in touch.

This information can be made available in a range of formats on request (eg Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre
Tel: 0191 246 7288

Published by the Patient Information Centre
2024 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

Ref, PIC/787/0224 February 2024 V4 V3
www.cntw.nhs.uk Tel: 0191 246 7288

Review date 2027