Which baseline assessment is essential before starting an atypical antipsychotic such as olanzapine?

• A. Baseline weight
• B. Orthostatic blood pressure
• C. Complete blood count
• D. Screening for tardive dyskinesia

Answer: (A)

Understanding the metabolic risk associated with atypical antipsychotics, especially olanzapine, is the key idea here. Olanzapine often causes significant weight gain and can lead to metabolic syndrome, so having a baseline weight establishes a reference point to detect meaningful increases over time. This helps you monitor and address changes early, whether through lifestyle interventions or considering alternative treatments.

Other options relate to safety monitoring, but they’re not as directly tied to olanzapine’s biggest risk. Orthostatic blood pressure checks are important in some patients for safety, but they don’t specifically capture the major metabolic danger. A baseline complete blood count is not routinely required solely because of starting olanzapine, and screening for tardive dyskinesia is important for long-term movement disorder risk, not the primary baseline concern when initiating this drug.