Weight gain and lipid-glucose profiles among patients taking antipsychotic medications: comparisons for prescriptions administered using algorithms versus usual care

Accessible summary • Metabolic disturbances, especially weight gain, are associated with the use of many psychotropic drugs. • Algorithms assist healthcare practitioners with decisions regarding appropriate medication treatment choices. • The use of evidence‐based practice guidelines has a positive effect on weight and triglycerides, and cholesterol. The purpose of this study was to determine if treatment strategy had a significant effect on the occurrence of physiological changes consistent with metabolic syndrome and/or type 2 diabetes in patients using atypical antipsychotic medications. The four variables assessed were: weight gain, fasting blood sugar, triglycerides and cholesterol. The two strategies compared were (1) evidence‐based practice, derived from the Texas Medication Algorithm Project, and (2) practitioner preference. A retrospective chart review was performed on patients diagnosed with a chronic psychiatric disorder being treated with atypical antipsychotics. The dates of the reviewed records were from 1 January 2008 to 31 December 2008. The sample of patients totaled 113. Statistical analysis included logistic regression for each of the four variables assessed. The use of evidence‐based practice guidelines was found to have strong positive effects on two of the four variables assessed. Further studies need to be conducted to include medications being taken to lower lipids and blood sugar. Overall, the use of evidence‐based practice guidelines has a positive effect on weight, triglycerides and cholesterol. It is important that patients be closely monitored and changes made in a timely manner to minimize adverse effects of atypical antipsychotics.