Baseline and follow-up laboratory investigations when initiating pharmacotherapy in patients with bipolar disorder

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.