Page 71 - e-book CPG - Bipolar Disorder

CLINICAL PRACTICE GUIDELINES MANAGEMENT OF BIPOLAR DISORDER (2ND ED.)

Appendix 7

Appendix 7
PARAMETERS FOR MONITORING DURING TREATMENT OF BIPOLAR DISEASE
Appendix 7

PARAMETERS FOR MONITORING DURING TREATMENT OF BIPOLAR DISEASE
Relevant physical examination and laboratory investigations should be performed before initiation of
PARAMETERS FOR MONITORING DURING TREATMENT OF BIPOLAR DISEASE
pharmacological treatment and at regular interval thereafter.

Relevant physical examination and laboratory investigations should be performed before initiation of
Relevant physical examination and laboratory investigations should be performed before initiation of

For all

pharmacological treatment and at regular interval thereafter.
Anti-
pharmacological treatment and at regular interval thereafter. Valproate Carbamazepine
patients at
Parameter
Lithium
first visit psychotics
For all
Anti-
For all

Parameter patients at Monthly for Every 6 Every 3 Carbamazepine
Anti-
Valproate
Lithium
Every 6
Yes
Weight (include
Valproate
Parameter
Carbamazepine
patients at
Lithium
psychotics
psychotics
waist size and first visit the first 3 months and months for months and
first visit
Weight (include Yes Monthly for Every 6 Every 3 Every 6
annually
BMI, if possible)
months and
annually
the first year
Every 6
Every 3
Monthly for
Yes
Every 6
Weight (include
waist size and the first 3 months and months for months and
and annually
thereafter*
*closer monitoring
thereafter*
annually
months and
waist size and
months and
months for
the first 3
BMI, if possible) months and annually the first year annually
if rapid weight
thereafter*
thereafter*
BMI, if possible)
months and
annually
annually
the first year
*closer monitoring annually thereafter* and annually thereafter*
gain
*closer monitoring
and annually
thereafter*
annually
thereafter*
if rapid weight
thereafter*
Blood pressure
thereafter*
thereafter*
if rapid weight
gain Yes thereafter* At every visit
gain
Blood pressure Yes Every 3 - 6 At every visit
Annually
Fasting blood
Yes
Blood pressure
sugar Yes months and At every visit
Fasting blood Yes Every 3 - 6 Annually
annually
Every 3 - 6
Annually
Fasting blood
Yes
sugar months and
thereafter
sugar months and
Electrocardiogram Yes annually If clinically If relevant
If relevant abnormalities are
annually

detected, recheck after each
thereafter indicated abnormalities
thereafter
Electrocardiogram Yes If relevant abnormalities are If clinically If relevant
dose increase
are detected,
Electrocardiogram Yes If relevant abnormalities are If clinically If relevant
detected, recheck after each indicated abnormalities
recheck
detected, recheck after each indicated abnormalities
dose increase are detected,
after each dose
dose increase are detected,
recheck
increase
recheck
Full blood count Yes Annually If clinically Every 3 after each dose
Monthly for the
after each dose
first 3 months
indicated months for increase
increase
Full blood count Yes Annually If clinically Every 3 Monthly for the
the first year
and annually
Full blood count Yes Annually If clinically Every 3 Monthly for the
indicated months for first 3 months
and annually
thereafter
indicated months for first 3 months
the first year and annually
thereafter
the first year
and annually
thereafter
Thyroid function Yes NA Every 6 and annually NA
thereafter
and annually
months, more thereafter
thereafter
Thyroid function Yes NA Every 6 NA
often if
Thyroid function Yes NA Every 6 NA
months, more
indicated
months, more
Every 6
Renal function Yes Annually often if Annually Every 6 months
often if
indicated
months, more
indicated
Renal function Yes Annually Every 6 Annually Every 6 months
often if
Renal function Yes Annually Every 6 Annually Every 6 months
months, more
indicated
months, more
often if
often if
indicated
Liver function Yes Annually Every 3 Monthly for the
indicated
months for first 3 months
Liver function Yes Annually Every 3 Monthly for the
the first year
and annually
Liver function Yes Annually Every 3 Monthly for the
months for first 3 months
thereafter
and annually
months for first 3 months
the first year and annually
thereafter
and annually
the first year
Annually thereafter
Lipid profile Yes Every 3 and annually thereafter
and annually
months for thereafter
thereafter
Lipid profile Yes Every 3 Annually
the first year
Lipid profile Yes Every 3 Annually
months for
and annually
months for
the first year
thereafter
the first year
Drug serum level NA and annually 1 week after Every 6 months
and annually
thereafter initiation and only if there is ineffectiveness,
thereafter
Drug serum level NA 1 week after poor adherence, or toxicity
Every 6 months
1 week after
Drug serum level NA 1 week after Every 6 months

every dose
initiation and
initiation and only if there is ineffectiveness,
only if there is ineffectiveness,
1 week after
poor adherence, or toxicity
change until
1 week after
every dose poor adherence, or toxicity
the level is
every dose
change until
stable, then
change until
the level is
the level is
stable, then
stable, then
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