When Was Your Last Bipolar Disorder Med Check?
When’s the last time you saw your doctor for a med check? A month ago? Six months ago? A year or more? Getting regular med checks, which can vary from weekly to quarterly depending on the level of acuteness of your symptoms, is important for a number of reasons:
- If you were placed on medications to treat acute mania or depression and you’re feeling better now, your doctor may want to remove certain medications and/or decrease dosages to maintenance levels. You don’t want to be taking more medication than necessary. During a major manic episode, for example, doctors often prescribe a mood stabilizer, such as lithium, along with an atypical antipsychotic, such as Zyprexa, and then gradually withdraw the atypical antipsychotic as the patient improves.
- With certain medications, including lithium and Depakote, you should have your blood levels checked regularly – more frequently when first starting the medication. On medications such as atypical antipsychotics, you should be getting regular laboratory tests to assess your glucose metabolism and your lipids – i.e. cholesterol. On lithium, you need to have your thyroid function monitored. Depending on your medication combination a variety of blood tests may be important . If it’s been 3 or 4 months since you have had any labs done and your doctor doesn’t bring it up, be sure to ask her if it might be time to check some blood tests.
- A number of medications require regular checking of your weight, and some psychiatric medications can affect blood pressure. If you’re on an atypical antipsychotic, the doctor will monitor for signs of weight gain and can help you discuss ways to address this early on if it starts to happen. Blood pressure problems can also be detected during these medication checks and may mean that a medication needs to be adjusted or changed.
- Medication checks give you a chance to talk to your doctor about side effects and possible ways to reduce or eliminate them. This lessens the likelihood that you’ll get frustrated with a side effect and just stop taking your medication. Regular discussions to address problems with the medicine improve outcomes and help to manage and/or reduce side effects.
- Some doctors tend to layer on medications without removing others. If you’re taking five or six different medications or two medications in the same class, such as two antidepressants or two antipsychotics, you may be taking unnecessary medications. In a study published in the Journal of Clinical Psychiatry Online, Dr. John O. Brooks, III, and colleagues discovered that “Patients with bipolar disorder treated with more than one second-generation antipsychotic drug do not do any better than those treated with one drug, and only have worse side effects.” Regular medication checks allow you and your doctor to review your medications and determine whether tapering or eliminating some redundant medicines is appropriate.
- Medication visits are an opportunity to discuss non-medication issues, such as nutrition and sleep/wake cycles and other medical issues that affect your illness and your medication.
- Regular medication checks are important in building a working relationship with your doctor and for both of you to be monitoring your patterns of symptoms, responses to medications, and side effects. Your doctor will be better able to help you if she knows you well and has gotten to know some of the patterns and problems over time – before a crisis. Communication and regular monitoring help to prevent crises in the first place, and if a major problem crops up, it enables your doctor to step in sooner rather than later with up-to-date information to help manage things.
A “med check” sounds like a drive-through check-in with your doctor, but it’s really much more than that. A number of issues should be checked and discussed as part of the foundation of long-term management of bipolar disorder.
Caution: Don’t stop taking a medication or adjust your medications without consulting your prescriber first.
If it’s been more than three months since you had your last med check, we encourage you to make an appointment to see your prescriber.
Fink, C. (2011). When Was Your Last Bipolar Disorder Med Check?. Psych Central. Retrieved on April 27, 2015, from http://blogs.psychcentral.com/bipolar/2011/06/bipolar-disorder-medication-check/