hardcross-taperantipsychotic switchingolanzapinearipiprazolemetabolic syndrome
A 33-year-old male with schizoaffective disorder has been maintained on olanzapine 20 mg daily for 2 years with adequate psychiatric symptom control. However, he has gained 45 pounds, his HbA1c has risen to 7.8%, and his fasting triglycerides are 295 mg/dL. After a collaborative discussion about risks and benefits, the decision is made to transition to a more metabolically favorable antipsychotic. He has previously tried risperidone with good psychiatric response but discontinued due to gynecomastia. His psychiatric symptoms are currently stable with a PANSS score of 52. Which cross-taper plan is most appropriate?