Medication Monitoring: Lab Tests & Safety Checks
Why psychiatric medications require monitoring: what tests are needed, how often, and how monitoring protects your health.
Clinically Reviewed: Board-Certified Psychiatrist |Next Review: May 2025
Key Takeaways
- Some psychiatric medications require lab monitoring to ensure safety and therapeutic levels
- Blood tests check kidney, liver, thyroid function and medication levels
- ECGs monitor heart rhythm for certain medications
- Metabolic monitoring tracks weight, blood sugar, cholesterol
- Regular monitoring catches problems early and allows dose adjustments
Why Monitoring Matters
Psychiatric medications can be highly effective, but some require regular monitoring to ensure they're working properly and not causing harmful effects. This monitoring protects your safety and helps optimize your treatment.
Common Monitoring Tests
Blood Level Monitoring
For: Lithium, valproate, carbamazepine
Ensures medication is at therapeutic level—not too low (ineffective) or too high (toxic). Requires periodic blood draws.
Kidney & Liver Function
For: Lithium, valproate, and others metabolized by kidneys/liver
Monitors organ function to ensure medication isn't causing harm. Allows early detection and intervention if problems arise.
Metabolic Panel (Blood Sugar, Cholesterol)
For: Atypical antipsychotics, some mood stabilizers
Screens for diabetes risk and cholesterol changes. Weight and waist circumference also tracked.
ECG (Electrocardiogram)
For: Medications that may affect heart rhythm
Baseline ECG before starting certain medications; repeat if dose increases or symptoms develop.
Frequently Asked Questions
Why do I need lab tests for psychiatric medications?
Lab tests ensure the medication is working at the right level in your body and not causing harmful effects on your organs. This is especially important for medications like lithium (affects kidneys/thyroid), valproate (affects liver), or antipsychotics (affect metabolism).
How often will I need blood work?
Depends on the medication. Lithium: every 1-2 weeks initially, then every 3-6 months. Valproate: similar schedule. Antipsychotics: baseline, then 3-6 months for metabolic monitoring. Your doctor will create a specific monitoring plan.
What happens if my lab results are abnormal?
Your doctor will review results with you. Minor abnormalities may just need monitoring. Significant changes may require dose adjustment, adding supportive treatments, or switching medications. Most issues can be managed if caught early.
Do antidepressants require lab monitoring?
Most SSRIs and SNRIs don't require regular blood tests once you're stable. However, we may check sodium levels if you're older or on certain medications. ECGs may be done for medications that can affect heart rhythm (citalopram, escitalopram at higher doses).
Why do I need to be weighed at appointments?
Some medications (especially antipsychotics and mood stabilizers) can cause weight gain or metabolic changes. Regular weight tracking helps us catch this early and address it before significant weight gain occurs.
What's a metabolic panel?
A metabolic panel checks blood sugar, cholesterol, and triglycerides. Some psychiatric medications (particularly atypical antipsychotics) can increase risk of diabetes and high cholesterol. We monitor these to protect your physical health.
Can I skip lab appointments if I feel fine?
No—many medication effects on organs happen without symptoms. You can feel perfectly fine while kidney function or thyroid is changing. Regular monitoring is essential for safe long-term medication use.
Will my insurance cover medication monitoring labs?
Most insurance plans cover medically necessary lab tests. We'll order only what's clinically indicated. If you have concerns about costs, discuss with our billing team before tests are ordered.
References
- 1. Malhi GS, et al. (2015). "Lithium monitoring in clinical practice." Bipolar Disorders 17(S2):1-17.
- 2. De Hert M, et al. (2011). "Physical illness in patients with severe mental disorders." World Psychiatry 10(1):52-77.