As a psychiatric provider, ordering the right baseline labs for schizophrenia is essential to assess your patient’s overall health and safely prescribe medications. Before starting treatment, labs help rule out medical conditions that might mimic or worsen psychiatric symptoms, such as thyroid disorders. Labs can also help determine which medications to prescribe. For example, if a patient’s lab results indicate metabolic syndrome, we might want to avoid certain medications that carry a heavy metabolic side effect profile.
Why Are Baseline Labs Important?
Baseline labs allow you to:
✔️ Evaluate the patient’s general medical status
✔️ Identify conditions that may influence or cause psychiatric symptoms (e.g., hyperthyroidism)
✔️ Prevent harm by monitoring labs relevant to medications’ side effects (like cardiac risks from QTc prolonging drugs)
What Labs Should You Order?
Baseline labs to order might include:
- Complete Blood Count (CBC) with differential
- Comprehensive Metabolic Panel (CMP)
- Thyroid Stimulating Hormone (TSH) and free T4
- Lipid panel
These labs provide a comprehensive overview of your patient’s organ function, blood health, and metabolic status and help ensure medications are prescribed safely. A helpful summary of these recommendations can be found here.
Medication-Specific Lab Monitoring
Certain psychiatric medications require additional attention. For example, in patients prescribed clozapine, you’ll want to closely monitor:
- Complete Blood Count with Differential, including Absolute Neutrophil Count (ANC)
- Comprehensive Metabolic Panel
- Fasting Lipids
This proactive lab monitoring supports safer medication use and early detection of adverse effects.
Overcoming Barriers to Lab Ordering
Many providers hesitate to order labs due to concerns about managing abnormal results or interpreting the data. However, avoiding labs can compromise patient safety and care quality. Instead, invest time in understanding key lab values and when to refer for specialist input.
Need Help Interpreting Labs?
Within my Mental Disorders Crash Course, I include a bonus guide—Stress Free Lab Interpretation (For Psych NPs Made Easy)—to help you confidently order and interpret lab work relevant to psychiatry.
You’ve Got This!
Understanding what labs to order and why empowers you to provide safe, effective mental health care. Don’t shy away from labs—embrace them as vital tools in your practice.