Metabolic syndrome and psychotropic monitoring

Meet the patient

A 26-year-old man started olanzapine six weeks ago for a first episode of psychosis. He is no longer frightened, and he has gained 7 kg. His fasting glucose, normal at baseline, is now in the prediabetes range. His mother, who has type 2 diabetes, asks whether the tablet that gave her son back is going to give him her disease.[5][8][18]

The exam question this vignette plants is the one registrars duck: do you stop the drug that works, or do you own the metabolic harm it is doing? The answer is neither panic-cessation nor therapeutic nihilism — it is rank, monitor, and act on trajectory. This topic is the prescribing spine behind that answer, and its monitoring intervals line up exactly with the antipsychotics and clozapine pages.[1][3][8][16]

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