Correct (2): Olanzapine carries the highest metabolic risk among atypical antipsychotics — significant weight gain, new-onset type 2 diabetes, and dyslipidemia. The ADA/APA consensus monitoring schedule includes weight/BMI, waist circumference, fasting glucose, and fasting lipids at baseline, 12 weeks, and at least annually, plus blood pressure. (1) QT prolongation is less concerning with olanzapine than with ziprasidone; ECG is not the primary monitor. (3) Coagulation tests are unrelated. (4) Thyroid is not the priority metabolic concern.
In-depth explanation
Memory Tip Highest metabolic risk: Olanzapine + Clozapine. Lowest: Aripiprazole + Lurasidone. Mid: Risperidone, Quetiapine. Clinical Practice Guide Apply the ADA/APA schedule for ANY atypical antipsychotic, even at low doses or short duration.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.