Atypical Antipsychotics

Tardive dyskinesia risk increases with age, longer treatment duration, and certain antipsychotic classes; higher-risk groups include older adults and those with comorbidities. Regular AIMS screening is recommended, with more frequent assessment for high-risk patients.

Metabolic monitoring includes weight, waist circumference, fasting glucose, and lipid panel at baseline, with follow-up intervals typically ranging from quarterly to annually. Metabolic risk varies among agents, with some associated with higher risk than others. Early detection of insulin resistance allows for timely intervention before full syndrome development.

Switching between antipsychotics is commonly done using a taper-overlap-taper strategy, with individualized adjustments based on the agents involved. Clozapine requires close monitoring during transitions, and bridging with another antipsychotic may be considered to prevent recurrence.