What we’ve said about Medication monitoring

“We're looking for kidney function, right? We're looking for thyroid function, and we're looking for calcium levels. That's the simplistic way of saying it. Those are the main ones that we're going to see being impacted on labs”

“high levels of lithium guarantee you decline of kidney function. High levels of Depakote do not guarantee any end-organ dysfunction necessarily. You've got to monitor for it, but it's not a guarantee. You're pretty much looking out for a low platelet issue. Hyperammonemia, the liver producing too much ammonia”

“Just warn about it. You don't need to get levels on oxcarbazepine, but you can. Some people do that. I don't find that very helpful clinically”

“Ordering labs is not as big a deal. It's not as time intensive as I once imagined. It's not like you need to go on a website and fax things and all these things. You can make a lab requisition form and give it to the patient”

“if you have a patient that absolutely you know is never going to follow up for labs, lithium probably is not the medication, the correct medication”

“I will titrate Up to the range of around 750 or even 900 depending on the reported adverse effects even without the first lab draw. But this is because I'm in a low resource clinic where despite my efforts many people will refuse or be unable to get lab draws”

“I'm willing to give up to 450 or maybe even 600 of lithium without labs in the long run if the patient is competent, has the capacity to understand the risks that they're taking on”

“I literally say to the patients, like the way I think about it is we don't do labs because this medication is unsafe. It's because we're doing this labs, this medication is extra safe”