**6.2.1 Baseline monitoring**

The recommendations are that baseline screening measures be obtained before or as soon as clinically feasible after, the initiation of any antipsychotic medication. We have to consider ethnicity, dietary habits, physical activity, support system, smoking, and alcohol and drug

Dyslipidemia and Mental Illness 361





All these drugs reduced major coronary events, CHD deaths but we have to be carefull with

Beyond the underlying risk factor, therapies directed against the lipid and nonlipid risk

The management of dyslipidemia in mental health is defined, as recommended by the Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes by: The lifestyle interventions with diet, increased physical activity and smoking cessation. They are the firs-line treatments to decrease the risk for cardiovascular disease in patient

Interventions that address nutrition and weight management should become a routine part of psychiatric care. Patients with mental illness did not know the components of a healthy


The lifestyle changes should be gradual and adapted individually for each patient. There are various educational and psychosocial programs that address the issues of health and wellness exist, like ' The Healthy Living' program (Vreeland, 2007; Hoffmann et al, 2006).

Patients who developed psychosis are more likely to be physically inactive (OR=3.3,95% CI 1.4-7.9) and to have poor cardio respiratory fitness (OR=2.2, 95% CI 0.6-7.8) compared with those who did not develop psychosis (Koivukangas et al, 2010). Modern guidelines on managing the physical health risks associated with schizophrenia include a recommendation about the importance of physical activity levels and fitness. This


Some studies showed that physical activity, with and without diet, resulted in modest weight loss, reduction of blood pressure and decreases in fasting plasma concentrations of



liver enzymes

with metabolic syndrome.


**7.3 Physical activity** 

recommendation includes:

most days of the week

glucose and insulin (Vancampfort et al, 2009).

diet. The healthy eating behavior includes:


index food items and monounsaturated fats

**7.2 Diet** 

and decreased absorption of some drugs

unexplained non-CHD deaths in WHO study

factors of the metabolic syndrome will reduce CHD risk.

(gout), upper gastrointestinal distress and hepatotoxicity

their side effects and contraindications when prescribing these drugs.

abuse. Keep in mind that psychotropic medications other than antipsychotic drugs such as some antidepressants and mood stabilizers may link to weight gain. The baseline assessments include:


If any abnormalities are identified, first, patients should be informed of their condition and supported in making lifestyle changes to adopt a healthier diet and increase physical activity. Psychiatrists should not hesitate to refer the patient to the appropriate health care professional or specialist knowledgeable about these disorders.

Even for patients free of metabolic disorders, monitor potential risk factors. Weight gain may not be dose-dependent and patients with low body mass index at baseline may be particularly vulnerable to weight gain. Glucose and lipid metabolism abnormalities may occur without weight gain.
