Majority of Medicaid patients on antipsychotic drugs do not undergo metabolic tests, says study

January 11, 2016

New prescriptions of olanzapine, which carries a higher metabolic risk, declined during the warning period. Prescriptions of the lower-risk drug aripiprazole increased, but this may also be attributable to the elimination of prior authorization for the drug in California during the same timeframe.

"Although this retrospective study was not able to identify or quantify reasons why laboratory screening did not increase after the FDA warnings, whereas prescribing practices did change, we might speculate on some possible explanations," the authors write. Switching to lower-risk drugs or avoiding drug treatment altogether may be simpler than the initiation of new screening procedures. In addition, although surveys have shown that psychiatrists are aware of the metabolic risk factors of these drugs, primary care providers who would generally order the necessary laboratory tests may not be.

"More effort is needed to ensure that patients who receive second-generation antipsychotic drugs are screened for diabetes and dyslipidemia and monitored for potential adverse drug effects, beginning with baseline testing of serum glucose and lipids, so that patients can receive appropriate preventive care and treatment," the authors conclude.