Table 16.6-3. Baseline and follow-up laboratory investigations in patients with bipolar disorders treated with pharmacotherapy

Baseline tests

– CBC with platelets

– Fasting glucose

– Fasting lipid profile (total cholesterol, VLDL, LDL, HDL, triglycerides)

– Electrolytes and calcium

– Liver enzymes

– Serum bilirubin

– Prothrombin time and partial thromboplastin time

– Urinalysis and urine toxicology (for substance use)

– Serum creatinine, 24-h creatinine clearance (if history of renal disease), and eGFR

– TSH

– ECG if age >40 years or if indicated

– Prolactin

– Pregnancy test (if relevant)

Follow-up testsa

– Lithium level: 1 week after each dose change, then every 6-12 months during maintenance

– TSH: 4-6 weeks after lithium initiation, then every 6-12 months

– CBC, electrolytes, eGFR/creatinine, calcium: 4-6 weeks after lithium initiation, then every 6-12 months

a Laboratory tests may be conducted more frequently depending on clinical concern (for example, DI or symptoms suggestive of hypothyroidism).

CBC, complete blood count; DI, diabetes insipidus; ECG, electrocardiography; eGFR, estimated glomerular filtration rate; HDL, high-density lipoprotein; LDL, low-density lipoprotein; TSH, thyroid-stimulating hormone; VLDL, very low–density lipoprotein.