Assessment

• Monitor mental status (mood, orientation, behavior) before and periodically during therapy

• Assess for suicidal tendencies, especially during early therapy. Restrict amount of drug available to patient

• Assess weight and BMI initially and throughout therapy

• Monitor blood pressure (sitting, standing, lying) and pulse before and frequently during initial dose titration. If hypotension occurs during dose titration, return to the previous dose

• Observe patient carefully when administering to ensure medication is swallowed and not hoarded or cheeked

• Monitor for onset of extrapyramidal side effects (akathisia—restlessness; dystonia—muscle spasms and twisting motions; or pseudoparkinsonism—mask-like faces, rigidity, tremors, drooling, shuffling gait, dysphagia). Report these symptoms; reduction of dose or discontinuation may be necessary. Trihexyphenidyl or benztropine may be used to control these symptoms

• Monitor for tardive dyskinesia (involuntary rhythmic movement of mouth, face, and extremities). Report immediately; may be irreversible

• Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness). Notify health care professional immediately if these symptoms occur

• May cause asymptomatic in AST and ALT

» May also cause anemia, thrombocytopenia, leukocytosis, and leukopenia

» May cause total cholesterol and triglycerides

» Obtain fasting blood glucose and cholestol levels initially and throughout therapy

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