As mentioned above, certain antipsychotics may increase the risk for diabetes and cardiovascular disease. When we combined data across states, we found that fewer than half of beneficiaries who received antipsychotics were screened for metabolic side effects or cardiovascular disease in 2007: 43 percent received cholesterol monitoring to screen for cardiovascular disease, and 13 percent received glucose monitoring to screen for diabetes.4
Lithium and some anticonvulsants (valproate and carbamazepine) should be regularly monitored through blood tests to ensure that beneficiaries receive an appropriate dosage and avoid toxicity. Across states, 66 percent of beneficiaries with bipolar disorder who received lithium had a blood lithium test during 2007. Fifty-four percent of beneficiaries who received valproate had their valproate level monitored, while 49 percent of those who received carbamazepine had their carbamazepine level monitored.