MONITORING ELEMENTS Monitoring of Thymoregulators The onset of action of a mood stabilizer is only observed after 2 to 3 weeks. The curative effectiveness is only assessed after a minimum period of 5 weeks. The preventive effectiveness can only be assessed over a period of one or two years with regular use. - Lithium salt monitoring It is preferable to initiate treatment within the framework of hospitalization. A complete clinical examination should be performed. Paraclinical examinations must also be requested with ECG, EEG, CBC, blood ionogram, blood sugar, urea, creatinine clearance, ultrasensitive TSH, 24-hour proteinuria, ßHCG. The therapeutic range is between 0.6 and 1.2 mmol/L. Once the therapeutic dose is reached, serum lithium levels should be monitored every 3 months. The diet must be standard-sodium (no salt-free diet). Clinical monitoring is required: weight, digestive disorders, sedation, thyroid goiter, signs of hypothyroidism, thirst, polyuria, skin manifestations must be regular. In addition, serum creatinine must be monitored for 6 months and an ultra TSH assay must be performed. -sensitive, CBC, ionogram, and an ECG/year. - Anticonvulsant monitoring: Valproate and carbamazepine A pre-therapeutic assessment is necessary including: a complete clinical examination and a biological assessment: CBC, coagulation assessment, ßHCG and a liver assessment. The therapeutic range for valproate is between 50 and 100 mg/l and that for carbamazepine between 5 and 12 mg/l. Tegretolemia or depakinemia should be monitored every 3 months and hematological and hepatic assessment every 3 to 6 months. - Monitoring of atypical antipsychotics (APA) A complete clinical examination must be carried out before initiating treatment with weighing, blood pressure measurement and ECG. The most common side effect of atypical antipsychotics is metabolic syndrome, so weight and blood pressure should be monitored and a metabolic assessment should be done if warning signs appear.
Monitoring of Antidepressants The antidepressant effect is only observed after 10 to 15 days of treatment. An antidepressant is considered ineffective if, at an adequate dose, there is no improvement after 6 weeks, or if improvement remains partial after 8 to 12 weeks of treatment. Antidepressants must be continued for at least 6 months after remission in the case of a first MDE, longer in the event of a recurrence in order to avoid relapses.