From the Guidelines
I strongly recommend checking thyroid function tests, complete blood count, and comprehensive metabolic panel to evaluate persistent irritability and anger, as these tests can help identify underlying medical conditions that may be contributing to these symptoms. According to the study by White and Barraclough 1, thyroid testing is suggested as a screening test, and abnormal thyroid test results can be related to mental illness. The study found that 10 thyroid test results were abnormal, and 5 of these patients were thought to have their mental illness related to the abnormal result.
When evaluating persistent irritability and anger, it is essential to consider the potential underlying medical causes. Some key laboratory tests that may be indicated include:
- Thyroid function tests (TSH, free T3, free T4) to evaluate for thyroid dysfunction, which can significantly impact mood regulation 1
- Complete blood count to check for anemia or other blood disorders that may contribute to irritability
- Comprehensive metabolic panel to evaluate for electrolyte imbalances, low blood sugar, or other metabolic disorders that may be contributing to symptoms
It is crucial to note that while laboratory tests are important, they should be ordered and interpreted by a healthcare provider in the context of the patient's symptoms and medical history. Additionally, psychological factors, sleep quality, and lifestyle elements also influence mood regulation, so a comprehensive evaluation may include both medical testing and mental health assessment 1.
The studies by Dolan and Mushlin, Ferguson and Dudleston, and Tintinalli et al 1 suggest that routine admission laboratory tests may not be necessary for all patients, and selective rather than routine laboratory ordering is recommended. However, in the context of evaluating persistent irritability and anger, the tests mentioned above may be indicated to rule out underlying medical conditions. Ultimately, a thorough medical evaluation, including laboratory tests and a physical examination, is necessary to determine the underlying cause of persistent irritability and anger.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Laboratory Tests for Evaluating Persistent Irritability and Anger
There are no direct laboratory tests mentioned in the provided studies that are specifically indicated for evaluating persistent irritability and anger. However, some studies suggest that certain physiological and psychological measures may be associated with irritability:
- Physiological measures:
- Psychological measures:
- Anger and anxiety ratings 2
- Multidimensional Assessment Profiles-Temper Loss scale (MAP-TL-Youth) 2
- Assessment of irritability using narrative and systematic review and meta-analysis of studies 4
- Evaluation of cognitive-behavioral processes, such as anger and sadness coping, intolerance of uncertainty, and rumination 5
Associated Conditions and Mechanisms
Irritability has been associated with various conditions, including:
- Depression and anxiety 4, 5
- Mood, anxiety, and substance use disorders 6
- Externalizing problems, such as reactive aggression and oppositionality 5
- Internalizing problems, such as depressive symptoms and anxiety 5
These conditions and mechanisms may be relevant to consider when evaluating persistent irritability and anger, although the specific laboratory tests used to assess them are not clearly indicated in the provided studies.