23 n Treatment with certain antipsychotic medications is associated with

23 n treatment with certain antipsychotic medications

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2,3 n Treatment with certain antipsychotic medications is associated with metabolic adverse events that can increase the risk for metabolic syndrome and related conditions such as pre-diabetes, type 2 diabetes, and cardiovascular disease. 4 The STABLE Resource Toolkit includes tools that will aid monitoring of EPS, TD symptoms and the common side-effects associated with antipsychotic medication usage. Abnormal Involuntary Movement (AIMS) n The AIMS scale was designed to measure involuntary movements known as tardive dyskinesia. TD is a disorder that can develop as a side-effect of long term treatment with neuroleptic (antipsychotic) medication. The Texas Medication Algorithm Project Side-effects Checklists n Medication side-effect self-report checklists, created by the Texas Medication Algorithm Project, lists common side-effects that should be reported to the clinician. n The two checklists include “Less Severe” and “More Severe” side-effects. Antipsychotic Side-effects Checklist (ASC) n The ASC was originally developed for use with schizophrenia on antipsychotic medication. The checklists are also useful in monitoring the side-effects of antipsychotics in the bipolar population. n The ASC was not designed to screen for TD or acute dystonia. Metabolic Monitoring Forms n The STABLE Metabolic Monitoring Form was designed as a tool to help clinicians organize the results of tests required for monitoring metabolic syndrome. The form includes tables for recording serial test results and provides normal and abnormal laboratory reference ranges. 1. Yatham LN, Kennedy SH, et al. Canadian Network for Mood and Anxiety Treatments of Bipolar Disorder (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies. Bipolar Disorders 2005: 7(Suppl 3): 5-69 2. Suppes T, Dennehy E, Hirschfeld R, et al. The Texas Implementation of Medication Algorithms: Update to the Algorithms for Treatment of Bipolar I Disorder, J Clin Psychiatry 2005 ; 66 :870-886. 3. Tarsy D, Baldessarini R, . Epidemiology of Tardive Dyskinesia: Is Risk Declining with Modern Antipsychotics? 4. Newcomer JW, Haupt DW, The Metabolic Effects of Antipsychotic Medications. Can J Psychiatry, Vol 51, No 8, July 2006; 480-491 PAGE ²´ STABLE RESOURCE TOOLKIT
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Abnormal Involuntary Movement Scale (AIMS) - Overview n The AIMS records the occurrence of tardive dyskinesia (TD) in patients receiving neuroleptic medications. n The AIMS test is used to detect TD and to follow the severity of a patient’s TD over time. Clinical Utility The AIMS is a 12 item anchored scale that is clinician administered and scored n Items 1-10 are rated on a 5 point anchored scale. • Items 1-4 assess orofacial movements. • Items 5-7 deal with extremity and truncal dyskinesia.
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