Treatment: antipsychotic
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Tests when starting treatment
Fasting laboratory tests
- Fasting plasma glucose
- Lipid profile
- Serum prolactin (before treatment, or if signs of hyperprolactinaemia)if neededBaseline measurement before treatment suggested by NICE [3]; on treatment, in the presence of galactorrhoea, amenorrhoea or oligomenorrhoea, gynaecomastia or sexual dysfunction, hormonal effects of antipsychotics [4].
- Serum electrolytesif neededHaloperidol: hypokalaemia and hypomagnesaemia, which increase the risk of ventricular arrhythmia, must be corrected before treatment; baseline electrolytes then regular checks [4].
- Serum magnesium (haloperidol)if neededHaloperidol: hypokalaemia and hypomagnesaemia, which increase the risk of ventricular arrhythmia, must be corrected before treatment; baseline electrolytes then regular checks [4].
Also consider
- Clozapine? An FBC is mandatory on clozapine: see the page "Treatment: clozapine".
- Lithium as well? If lithium is added, see the page "Treatment: lithium".
- Antiepileptic as well? If an antiepileptic is added, see the page "Traitement : antiépileptiques".
Do not order
Annual tests
Fasting laboratory tests
- Fasting plasma glucose
- Lipid profile (if annual lipid monitoring is chosen, as in the United Kingdom and the United States)if needednon-French guidelineAnnual lipid profile: NICE (UK) asks for it at 12 weeks, at 1 year then every year, and the APA (United States, 2020) at 4 months then at least once a year [3,9]; the 2010 French update and the olanzapine SmPC provide for it every 5 years if the profile is normal [5,7].
Every 5 years
Fasting laboratory tests
- Lipid profile
- Fasting plasma glucose
Sources (12)
- Assurance maladie. Cartographie des pathologies et des dépenses, effectifs 2024 (data.ameli.fr, jeu « effectifs »), consulté le 24/10/2026.
- Assurance maladie. Open Medic 2024, base « nombre de consommants » par code ATC5 (fichier NB_2024_atc5), open-data-assurance-maladie.ameli.fr, téléchargé le 23/10/2026, relu le 24/10/2026.
- National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management. Clinical guideline CG178, 2014 (mise à jour 2021).
- Base de données publique des médicaments. HALDOL 5 mg, comprimé (halopéridol) : résumé des caractéristiques du produit, rubrique 4.4.
- Afssaps (ANSM). Suivi cardio-métabolique des patients traités par antipsychotiques. Mise au point, mars 2010.
- American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care. 2004;27(2):596-601.
- Agence européenne des médicaments. Zyprexa (olanzapine) : résumé des caractéristiques du produit, rubrique 4.4.
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : acte 1577 (HbA1c).
- American Psychiatric Association. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia, Third Edition. Washington, DC : APA, 2020 (tableau 2, repris dans le diaporama de formation officiel de l'APA).
- National Institute for Health and Care Excellence. Bipolar disorder: assessment and management. Clinical guideline CG185, septembre 2014 (mise à jour septembre 2025).
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN). S3-Leitlinie Schizophrenie (living), Langfassung, AWMF-Registernummer 038-009, version MAGICapp du 17/10/2025 (fichier de décembre 2025).
- Assurance maladie. Table nationale de biologie (NABM), version 105 du 2 juin 2026 : note de présentation (complément à la cotation minimale, code 9915).