Investigations explained

Here’s an explanation of why each investigation might be important in the management of a patient with mania:

1. FBC (Full Blood Count): Mania can be associated with physical health changes that may influence blood components. An FBC can help detect infections, anemia, or blood disorders that might affect mood or overall health, or could be side effects of medications used in treatment.

2. U&Es (Urea and Electrolytes): Electrolyte imbalances are common in patients with mania, especially if they have altered eating or drinking habits or are taking medications that affect kidney function. Monitoring urea and electrolytes can reveal dehydration, kidney issues, or other metabolic disturbances that may exacerbate symptoms.

3. LFT (Liver Function Tests): Many medications used to treat mania, such as mood stabilizers, can impact liver function. LFTs help detect liver abnormalities that could affect medication choice or dosage.

4. KFT (Kidney Function Tests): Mood stabilizers, especially lithium, require kidney function monitoring as they can affect the kidneys over time. KFTs are essential to assess the patient’s renal health before starting or adjusting medications.

5. RPR (Rapid Plasma Reagin) and HIV Testing: These tests screen for syphilis and HIV, both of which can present with neuropsychiatric symptoms, including mania. Detecting or ruling out these infections helps ensure an accurate diagnosis and appropriate treatment.

6. TSH (Thyroid Stimulating Hormone): Thyroid dysfunction, particularly hyperthyroidism, can mimic or exacerbate manic symptoms. TSH testing is necessary to rule out thyroid-related causes of mania.

7. Hepatitis B and C Testing: Patients with hepatitis B or C may require special considerations when prescribing certain psychiatric medications. Chronic hepatitis infections can also affect the liver, impacting drug metabolism and overall treatment strategy.

8. Vitamin B12 Levels: Low B12 levels can lead to neuropsychiatric symptoms, including mood changes and cognitive disturbances, which can resemble mania. Testing B12 levels ensures that any deficiencies are corrected, possibly improving the patient’s symptoms.

9. Pregnancy Test: Certain medications used in treating mania, such as mood stabilizers and antipsychotics, can be harmful during pregnancy. A pregnancy test is necessary to safely guide medication choices for female patients of childbearing age.

10. MRI (Magnetic Resonance Imaging): An MRI can help rule out structural brain abnormalities, such as tumors, lesions, or other neurological conditions that might mimic or exacerbate manic symptoms.

11. CT Scan (Computed Tomography Scan): A CT scan can be used similarly to MRI to identify any structural or vascular brain abnormalities, which may need to be considered as underlying or contributing factors to manic episodes.

12. DOA6 (Drugs of Abuse - 6 Panel): Substance use can trigger or worsen manic episodes. A drug panel is useful to rule out or confirm the influence of substances, such as stimulants or hallucinogens, which could be affecting the patient’s mental state.

13. EEG (Electroencephalogram): An EEG may help differentiate mania from seizure disorders or other neurological conditions with similar symptoms, such as temporal lobe epilepsy, which can present with mood changes and mania-like symptoms.

14. ECG (Electrocardiogram): Medications used in treating mania, especially antipsychotics and mood stabilizers, can affect cardiac function. An ECG is essential to detect any pre-existing heart issues or medication-induced cardiac side effects, ensuring safe pharmacological management.