46 - Physical monitoring for people with bipolar d

Physical monitoring for people with bipolar disorder1,2

Physical monitoring for people with bipolar disorder1,2 Monitoring for all patients Additional monitoring for specific drugs Test or measurement Initial health check Annual check-up Antipsychotics Lithium Valproate Carbamazepine Thyroid function Yes Yes At start and every 6 months. More often if evidence of change. Liver function tests (LFTs) Yes Yes Every 3 months for the first year then annually Monthly for the first 3 months then annually Renal function (eGFR) Yes Yes At start and every 6 months. More often if there is evidence of deterioration or the patient starts taking interacting drugs. Electrolytes, urea and creatinine (EUC) Yes Yes At start and then every 3–­6 months (include serum calcium) Monthly for the first 3 months then annually Full blood count (FBC) Yes Yes Only if clinically indicated Every 3 months for the first year then annually Monthly for the first 3 months then annually Blood (plasma) glucose Yes Yes, as part of a routine physical health check At start and then every 4–­6 months (and at 1 month if taking olanzapine); more often if evidence of elevated levels Lipid profile Yes Yes, as part of a routine physical health check At start and at 3 months; more often initially if evidence of elevated levels Blood pressure and pulse Yes Yes, as part of a routine physical health check During dosage titration if antipsychotic prescribed is associated with postural hypotension