Table 1.
Initial Evaluation of Suspected Bipolar Disordera
| Tests to aid diagnosis | Thyroid function test, rapid plasma reagin test for syphilis, urine drug screen, B12 level, and careful history to screen for other secondary causes of mood symptoms (see) | Consider neuroimaging for first episode, electroencephalogram if indicated, HIV test if applicable, and expanded toxicologic screen if suspicion of substance-induced episode is high |
| Tests to guide treatment and health maintenance | General: personal and family history of metabolic/cardiac disease; prior to lithium treatment: thyroid function test, complete blood count, urinalysis, electrocardiogram (≥ 40 y), electrolytes | Consider 24-hour urine creatinine for lithium treatment, evaluation for cataracts with quetiapine treatment, evaluation of menstrual irregularity with divalproex, initial screening for rash prior to lamotrigine treatment |
| Prior to treatment with anticonvulsants: complete blood count, liver function, electrolytes, weight/body mass index | ||
| Prior to treatment with antipsychotics: screen for extrapyramidal/motor symptoms, metabolic syndrome (body mass index, waist circumference, blood pressure, lipid profile, fasting glucose) |