I want to start a conversation on regular blood testing, while people are taking various types of bipolar medications.

I know that some bipolar medications (Lithium, Depakote, Carbamazepine, etc) require regular, or at least frequent initial, blood levels to be taken in order to ensure therapeutic doses and prevent toxicity. There are also other recommended blood tests when on these medications, such as to monitor kidney and thyroid functioning, sodium levels, and blood cell counts, just to name some. I know that my doctors are also concerned about how these and other bipolar medications (i.e. antipsychotics) affect my cholesterol, triglycerides, glucose levels, (heart, in general), etc.

Question 1: For anyone who has taken carbamazepine (Tegretol) for extended periods, how often did your psychiatrist (or other doctor) order carbamazepine levels (in the beginning and then later down the line)?

Hi Birdie, I'm not on those meds, so I hope it's okay to reply to the rest of your post.

Question 2: How often do you get comprehensive metabolic panel, lipid panel, hemoglobin, TSH/T4/T3 (thyroid) blood tests done? And who orders them? If someone other than your psychiatrist, are the results shared with your psychiatrist?

I get all of the above done right about every six months. If my GP orders them they are shared with my pdoc. And vice-versa. In fact, I am due this month for all the blood work. My pdoc will be ordering it.

Question 3: Have (or do) you get other types of testing done that in some way relates to your bipolar medications? For example, EKG, MRI, etc? If so, how often and who orders them?

Nope!

They seem to like to wait until some serious health problem appears, rather than using preventative medicine.

For example, I've heard all sorts of this and that about the atypical AP's causing dangerous cardiac problems in some people. Even though I have a history of major cardiac disease in my family, no MD listens to me when I mention having an EKG...they basically blow me off.

I've thought about truly assertive about an EKG, though. I believe it's something that needs to be done after having been on AP's for so very many years.

Some years ago I was seeing an especially thorough and responsible pdoc; she ordered an MRI (brain). I have never had any other MD of any kind send me for tests having to do with my meds other than blood work.

If you wonder if/when you should have any of the above tests done, it might be good to discuss with your psychiatrist and general practitioner.

Yes - and be persistent!