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)?

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?

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?

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.