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Table 3 Monitoring of physical and laboratory parameters

From: Monitoring of patients treated with lithium for bipolar disorder: an international survey

Parameter Monitoring before start of treatment Frequency of monitoring during the first 6 months of treatment Frequency of monitoring per year during maintenance treatment
Never 1–3× ≥ 4× Never Once 2–3× ≥ 4×
Physical parameters
 Physical parameters (at least one parameter) 104 (88%) 17 (14%) 76 (64%) 24 (21%) 12 (10%) 58 (49%) 28 (24%) 19 (16%)
 Body weight 92 (79%) 32 (27%) 70 (60%) 15 (13%) 20 (17%) 58 (50%) 25 (21%) 14 (12%)
 Blood pressure 88 (75%) 35 (30%) 63 (54%) 19 (16%) 28 (24%) 51 (44%) 24 (21%) 14 (12%)
 Pulse 79 (68%) 43 (37%) 56 (48%) 18 (15%) 38 (32%) 48 (41%) 19 (16%) 12 (10%)
 Body mass index (BMI) 63 (54%) 54 (46%) 54 (46%) 9 (8%) 45 (38%) 47 (40%) 16 (14%) 9 (8%)
 Electrocardiogram (ECG) 51 (44%) 66 (56%) 46 (39%) 5 (4%) 71 (61%) 31 (27%) 12 (10%) 3 (3%)
 Waist circumference 45 (38%) 72 (62%) 42 (36%) 3 (3%) 65 (56%) 38 (32%) 9 (8%) 5 (4%)
 Pregnancy test 40 (34%) 90 (77%) 24 (21%) 3 (3%) 102 (87%) 7 (6%) 6 (5%) 2 (2%)
 24 h urine examination 23 (20%) 93 (79%) 21 (18%) 3 (3%) 88 (75%) 23 (20%) 2 (2%) 4 (3%)
Renal function
 Renal function (at least one parameter) 116 (99%) 3 (3%) 88 (75%) 26 (22%) 0 25 (21%) 60 (51%) 32 (27%)
 Creatinine 116 (99%) 3 (3%) 88 (75%) 26 (22%) 0 26 (22%) 59 (50%) 32 (27%)
 Urea 101 (86%) 21 (18%) 78 (67%) 18 (15%) 18 (15%) 22 (19%) 48 (41%) 29 (25%)
 Glomerular filtration rate (GFR) 100 (85%) 19 (16%) 76 (65%) 22 (19%) 13 (11%) 22 (19%) 52 (44%) 30 (26%)
 Albumin 66 (56%) 46 (39%) 60 (51%) 11 (9%) 42 (36%) 21 (18%) 34 (29%) 20 (17%)
Thyroid function
 Thyroid function (at least one parameter) 115 (98%) 2 (2%) 104 (89%) 11 (9%) 0 43 (36%) 54 (46%) 20 (17%)
 Thyroid stimulating hormone (TSH) 115 (98%) 2 (2%) 104 (89%) 11 (9%) 1 (1%) 42 (36%) 54 (46%) 20 (17%)
 Thyroxine (T4) 82 (70%) 30 (26%) 80 (68%) 7 (6%) 28 (24%) 33 (28%) 41 (35%) 15 (13%)
Parathyroid function
 Parathyroid hormone (PTH) 32 (27%) 79 (68%) 35 (30%) 3 (3%) 72 (62%) 22 (19%) 17 (15%) 6 (5%)
Electrolytes
 Electrolytes (at least one parameter) 107 (91%) 10 (9%) 86 (73%) 21 (18%) 8 (7%) 34 (29%) 49 (42%) 26 (22%)
 Sodium 103 (88%) 17 (15%) 80 (68%) 20 (17%) 14 (12%) 32 (27%) 46 (39%) 25 (21%)
 Potassium 101 (86%) 18 (15%) 79 (68%) 20 (17%) 15 (13%) 32 (27%) 45 (38%) 25 (21%)
 Calcium 94 (80%) 21 (18%) 81 (69%) 15 (13%) 19 (16%) 35 (30%) 44 (38%) 19 (16%)
Hematological parameters
 Hematological parameters (at least one parameter) 106 (90%) 26 (22%) 79 (67%) 12 (10%) 24 (21%) 51 (44%) 29 (25%) 13 (11%)
 Full blood count 102 (87%) 32 (27%) 73 (62%) 12 (10%) 30 (26%) 47 (40%) 29 (25%) 11 (9%)
 Leukocytes 101 (86%) 30 (26%) 75 (64%) 12 (10%) 27 (23%) 50 (43%) 27 (23%) 13 (11%)
 Leukocyte differentiation 87 (74%) 40 (34%) 67 (57%) 10 (9%) 38 (32%) 45 (38%) 25 (21%) 9 (8%)
Lipid profile
 Lipid profile (at least one parameter) 73 (62%) 57 (49%) 55 (47%) 5 (4%) 42 (36%) 53 (45%) 18 (15%) 4 (3%)
 Triglycerides 71 (61%) 58 (50%) 54 (46%) 5 (4%) 43 (37%) 52 (44%) 18 (15%) 4 (3%)
 Total cholesterol 71 (61%) 59 (50%) 53 (45%) 5 (4%) 44 (38%) 52 (44%) 17 (15%) 4 (3%)
 High density lipoprotein (HDL) 69 (59%) 60 (51%) 53 (45%) 4 (3%) 45 (38%) 51 (44%) 18 (15%) 3 (3%)
 Low density lipoprotein (LDL) 67 (57%) 63 (54%) 50 (43%) 4 (3%) 48 (41%) 49 (42%) 17 (15%) 3 (3%)
 Very low density lipoprotein (vLDL) 35 (30%) 84 (72%) 32 (27%) 1 (1%) 71 (61%) 35 (30%) 11 (9%) 0
Hepatic function
 Hepatic function (at least one parameter) 68 (58%) 61 (52%) 48 (41%) 8 (7%) 54 (46%) 37 (32%) 20 (17%) 6 (5%)
 Alanine aminotransferase (ALAT) 68 (58%) 62 (53%) 47 (40%) 8 (7%) 55 (47%) 37 (32%) 19 (16%) 6 (5%)
 Aspartate aminotransferase (ASAT) 66 (56%) 64 (55%) 46 (39%) 7 (6%) 55 (47%) 37 (32%) 19 (16%) 6 (5%)
 Bilirubin 34 (29%) 79 (68%) 33 (28%) 5 (4%) 71 (61%) 27 (23%) 15 (13%) 3 (3%)
Other laboratory parameters
 Fasting glucose 79 (67%) 48 (41%) 63 (54%) 6 (5%) 35 (30%) 56 (48%) 20 (17%) 6 (5%)
  1. Italicized cells represent most reported answers after initiation of lithium treatment