Risperidone, Olanzapine, Aripiprazole, Haloperidol, Trihexyphenidyl (only if EPS)
Advice and when to refer
Monitor: Weight, glucose, lipids, BP at baseline, 12 wk, then yearly; clozapine after 2 failed antipsychotics (psychiatrist) (NICE CG178 2026; APA 2020)
Investigations
First visit
Weight, waist, BP — Baseline before antipsychotics.
Fasting glucose or HbA1c, lipid profile — Metabolic baseline.
CBC, LFT, creatinine, TSH — Baseline and medical causes.
Only if indicated
ECG — Heart disease, family history of sudden death, or QT-prolonging drugs.
Prolactin — Sexual side effects or breast milk on antipsychotics.
Urine drug screen — Possible substance use.
MRI brain — First episode with atypical or neurological features.
Follow-up and monitoring
Weight monthly for 3 months; glucose and lipids at 3 months, then yearly — Metabolic monitoring.
CBC weekly for 18 weeks — Clozapine (neutropenia), then monthly.
Locked
The adult dose for each drug
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.