Safety monitoring of treatment in bipolar disorder in a tertiary care setting in Sri Lanka and recommendations for improved monitoring in resource limited settings

Table 5 Monitoring criteria used as per ISBD guidelines and our recommendations (Ng et al., 2009)

Drug	Monitoring factor	Time interval recommended by the ISBD	Our recommendations
Lithium	Serum lithium, Electrolytes, Urea and Creatinine	Every 3–6 months	At least every 6 months in 80% patients for serum lithium and 70% for other tests
Lithium	Calcium and Thyroid Stimulating Hormone	Annually	Annually for majority of patients
Sodium valproate	Full blood count and Liver Function Tests	Annually	Annually for majority
Sodium valproate	Therapeutic drug monitoring of sodium valproate, Fasting blood glucose and Lipid Profile	When clinically indicated	When clinically indicated
Carbamazepine	Full blood count, Liver Function Tests, Electrolytes, Urea and Creatinine	Annually	Annually for majority
Carbamazepine	Therapeutic drug monitoring of carbamazepine	When clinically indicated	When clinically indicated
Atypical antipsychotics e.g.: Olanzapine, Risperidone, Quetiapine	Fasting blood glucose and fasting lipid profile	Annually	Annually for majority

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