các lớp học toàn bộ các thuốc chống loạn thần không điển hình, nguy cơ không xuất hiện lớn nhất với clozapine và olanzapine. Hội nghị Phát triển Đồng thuận về thuốc chống loạn thần và béo phì và bệnh tiểu đường đã khuyến nghị để sàng lọc trước khi điều trị bằng thuốc chống loạn thần không điển hình | 98 HANDBOOK OF PSYCHIATRIC DRUGS TABLE 3-5. Atypicals in the Treatment of Acute Mania GENERIC NAME BRAND NAME DOSE ON FIRST DAY ACUTE DOSE ADJUSTMENT MAINTENANCE DOSE Aripiprazole Ability 15-30 mg . - 15-30 mg . Olanzapine Zyprexa 10-15 . increments of 5-20 mg . 5 mg per day Quetiapine Seroquel 50mg . 200 mg . by 200-400 mg day 4 in increments of 50 mg . . Risperidone Risperdal 2-3 mg . increments of 1-6mg . 1 mg per day Ziprasidone Geodon po 40 mg . 60-80mg . on day 2 40-80 mg . Geodon 10mg q2hr im the entire class of atypical antipsychotics the risk does appear to be greatest with clozapine and olanzapine. The Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes has made recommendations for screening prior to treatment with an atypical antipsychotic and for monitoring during treatment. Before starting the medication weigh potential benefits against metabolic and medical risks based upon the following assessments Personal and family history of diabetes obesity hyperlipidemia hypertension and cardiovascular disease Baseline height and weight which should be used to calculate the body mass index BMI and waist circumference measured at the height of the umbilicus Blood pressure Fasting plasma glucose Fasting lipid profile The presence of metabolic abnormalities or significant personal or family history might prompt preferential use of atypical antipsychotics with lower risk ziprasidone or aripipra-zole or intermediate risk risperidone or quetiapine relative to higher risk olanzapine and clozapine . MOOD STABILIZERS 99 Follow up monitoring of patients on atypical antipsychotics should be conducted as follows Review personal and family history annually. Measure weight and BMI at 4 8 and 12 weeks then quarterly. Measure waist circumference annually. Measure blood pressure and fasting plasma glucose at 12 weeks then annually. Measure fasting lipids at 12 weeks then every five .
