Monitoring the Physical Health of Patients on Long‐term Antipsychotics ‐ How Easy Will It Be?

Publication Date01 Jun 2007
AuthorKauser Ahmad,Fareeha Sadiq,Joe Bouch
Mental Health Review Journal Volume 12 Issue 2 June 2007 © Pavilion Journals (Brighton) Ltd
Kauser Yasmeen Ahmad
Locum Staff Grade, Learning Disabilities Psychiatry, Gartnavel Royal Hospital, Glasgow (SHO at time of study)
Fareeha Amber Sadiq
Senior House Officer, Gartnavel Royal Hospital, Glasgow
Joe Bouch
Consultant Psychiatrist, Gartnavel Royal Hospital, Glasgow
Monitoring the Physical Health
of Patients on Long-term
Antipsychotics –
How Easy Will It Be?
The physical health of patients with severe mental illness is often neglected or managed poorly, and regular review
of physical health is now being strongly advised. The study described here explored the feasibility of such reviews
in a community mental health care setting. A small group of patients was invited to attend for blood tests and a brief
physical examination. The findings from the study suggest that the monitoring of patients with severe enduring
mental illness is an important but difficult task. It will require careful planning and the engagement of patients,
general practitioners and community mental health teams.
Key words
Physical health, health checks, long-term antipsychotics, severe mental illness
mechanism is unclear,the prevalence of these risk
factors has been recognised. Moreover weight gain
may contribute to stigmatisation, non-compliance with
medications and social withdrawal (Harrison, 2004).
The Consensus Development Conference on
Antipsychotic Drugs, Obesity and Diabetes was
convened in November 2003. An eight-member panel
heard presentations from experts in related fields and
examined clinical studies and papers. The consensus
statement (American Diabetes Association et al, 2004)
emphasised the need for both baseline screening and
monitoring to minimise the risk of development of
diabetes, dyslipidaemia and cardiovascular
complications secondary to weight gain from atypical
antipsychotics. There have been many studies on the
metabolic effects of antipsychotics and even though
they may differ in their recommendations regarding
follow-up and intervention, all have stressed the
The association between severe mental illness (SMI)
and poor physical health is confirmed and well
documented (Ryan et al, 2003). Patients with severe
and enduring mental illness (SEMI) have increased
morbidity and mortality secondary to lifestyle factors
such as increased levels of smoking and a lack
of exercise, as well as antipsychotic medication
(McCreadie, 2003).This also contributes to poor
dental hygiene leading to dental caries and
periodontal diseases, made worse by non-attendance
at dental clinics (British Society for Disability and
Oral Health, 2000).
Antipsychotics are known to cause unpleasant
side-effects including weight gain (Newcomer,2004).
A close link has been found between weight gain
following use of atypical antipsychotics and the
development of diabetes, dyslipidaemia and
cardiovascular problems. Even though the exact

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