Lab monitoring is crucial for managing side effects and making sure you’re taking the best dose for your symptoms.
It’s common to have your blood drawn when taking certain medications. A simple blood test can tell so much.
Specific labs can give a doctor an idea of your general state of health and can hint at how your body is responding to any treatment you’re receiving.
Psychiatric medications can cause unwanted side effects. And, the dose isn’t always quite right for you at first.
Labs can help ensure the medication performs its job at the right dose, as well as monitor you for any serious side effects.
Medication can help manage a mental health condition or symptom, but it may cause other effects, too. Lab monitoring can help prevent this from happening and ensure the side effects you’re experiencing don’t get worse.
For example, according to the National Alliance on Mental Illness (NAMI), atypical antipsychotics such as aripiprazole (Abilify) can increase your chance of medical conditions such as:
A healthcare or mental health professional will monitor your levels regularly to prevent this. They might also recommend a change in your dose or diet to help.
The specific labs you need will depend on the medication you’re taking. Some common types of monitored psychiatric medications include:
Typical antipsychotics work by blocking some of the dopamine receptors in your brain. This leads to fewer symptoms of psychosis.
They treat many conditions, including:
- schizophrenia and schizoaffective disorders
- manic episodes
- major depressive disorder
- delusional disorder
- severe agitation due to dementia or delirium
- Tourette’s disorder
- borderline personality disorder
- dementia and delirium
- substance-induced psychotic disorder
The medications found in this drug class that may require monitoring include:
- chlorpromazine (Thorazine)
- fluphenazine (Prolixin)
- haloperidol (Haldol)
- loxapine (Loxitane)
- perphenazine (Trilafon)
- thiothixene (Navane)
- thioridazine (Mellaril)
- trifluoperazine (Stelazine)
Like typical antipsychotics, atypicals treat symptoms of psychosis. But they work differently, and there are fewer side effects.
Atypical antipsychotics that might require lab monitoring include:
- aripiprazole (Abilify)
- asenapine (Saphris)
- brexpiprazole (Rexulti)
- cariprazine (Vraylar)
- clozapine (Clozaril)
- iloperidone (Fanapt)
- lumateperone (Caplyta)
- lurasidone (Latuda)
- olanzapine (Zyprexa)
- paliperidone (Invega)
- quetiapine (Seroquel)
- risperidone (Risperdal)
- ziprasidone (Geodon)
Mood stabilizers manage and treat bipolar disorder. They work to:
- reduce mood swings
- prevent manic episodes
- lessen depression
The mood stabilizers frequently monitored are:
- carbamazepine (Tegretol)
- divalproex sodium (Depakote)
- gabapentin (Neurontin)
- lamotrigine (Lamictal)
- lithium (Eskalith)
- oxcarbazepine (Trileptal)
- topiramate (Topamax)
- valproic acid (Depakene)
Substance use treatment
Treatment for substance use disorder may include medication. These medications may help by reducing cravings and withdrawal symptoms.
The substance use treatment medications that may require close monitoring include:
- acamprosate (Campral)
- buprenorphine (Subutex)
- buprenorphine/naloxone (Suboxone)
- disulfiram (Antabuse)
- naltrexone (Vivitrol)
The typical labs monitored vary depending on the medication. But some standard tests are:
- Basic/comprehensive metabolic panel (BMP/CMP): assesses the natural blood chemicals, giving insight into your organ function
- Complete blood cell count (CBC): one of the most common
blood testsmeasuring the different parts of your blood, such as red blood cells, white blood cells, and platelet and hemoglobin levels
- Drug-specific level: rates the amount of medication in the blood to correctly dose and prevent toxicity
- Electrolytes: checks sodium and other electrolyte levels needed for daily functioning
- Fasting blood glucose: some medications impact blood sugar control, so checking your blood sugar can be crucial
- Hemoglobin A1C: tracks blood sugar control over time
- Hepatic (liver) function panel: shows your liver function and helps to check for any damage or rule out other concerns
- HLA-A or HLA-B: measures your leukocyte antigens to determine how sensitive you might be to certain medications
- Lipid panel: sometimes done while fasting to measure your cholesterol and triglycerides levels
- Liver enzymes (ALT/AST): a rise in enzymes can indicate damage to the liver, possibly caused by your medication
- Pregnancy test: certain medications can harm the fetus, so this may be checked at the start and during treatment
- Prolactin level: changes in dopamine may lead to an overproduction of prolactin
- Renal function panel: some medications may cause damage to the kidneys and bladder
- Troponin: antipsychotics can affect the heart, and this test shows if there’s any damage to the muscle
- Thyroid stimulating hormone (TSH): a
2018 studyfound that this hormone may be changed when taking antipsychotic medications
- Thyroid studies: looks at thyroid gland function
- Urinalysis (UA): when taking lithium, it’s crucial to monitor your urine for any blood or protein since it can affect your kidneys
Here’s a breakdown of the common lab tests for each group of psychiatric medications.
- fasting blood glucose or hemoglobin A1C
- fasting lipid profile
- fasting blood glucose of hemoglobin A1C
- drug-specific level
- hepatic function panel
- HLA-A and HLA-B
- renal function test
- thyroid studies
Substance use treatment
- liver function test
If your values are out of range, it can mean different things.
For example, if the drug-specific level is too high, you may need to skip a dose or lower your dosage. It’s not recommended that you decide when to take either of these actions.
A doctor will work with you to determine what’s best for you based on your medical history and symptoms.
If your labs show damage to your organs or blood, such as the kidneys, your dose may be adjusted, or you may be switched to a different medication.
Medications can sometimes cause unwanted side effects, but their benefits may outweigh the side effects.
If you’re living with schizophrenia, antipsychotics can help you function daily. But you may notice a rise in your blood sugar levels.
You and your doctor can decide on whether a new diet or adding another medication can help you manage this. These steps might be better than stopping your medication.
Lab monitoring can help a healthcare or mental health professional determine whether the medication level is in range in your body and whether you may be experiencing any serious side effects.
Lab draws typically occur before starting a new medication and while taking it.
If you have a fear of needles, this may be scary. But you’re not alone. Many people are uncomfortable with injections.
Lab monitoring can help determine the best medication dose for you, your symptoms, and your condition.
If you need help finding mental health support, you can check out Psych Central’s hub to help you find a therapist who can offer coping mechanisms and other tips.