Case report
https://doi.org/10.21860/medflum2021_365349
Treatment of bipolar affective disorder during pregnancy: case report
Rafaela Jurman
orcid.org/0000-0002-7018-703X
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Gordana Rubeša
orcid.org/0000-0002-8751-1721
; Klinika za psihijatriju i psihološku medicinu, KBC Rijeka, Rijeka, Hrvatska
Abstract
Aim: To report a case of a pregnant woman with bipolar affective disorder (BAD) and therapeutic challenges in her treatment. Case report: A 35-year-old pregnant woman was hospitalized at the psychiatric clinic due to psychotic decompensation from a previously diagnosed BAD. The patient was hospitalized several times due to BAD. She was first hospitalized at the age of 25. Since than, despite regular check-ups and medication, there have been several deteriorations in mental health, mostly manic episodes. At the age of 35 the patient got pregnant and the previously recommended therapy was corrected. Lithium was abolished and sodium valproate was introduced. After four weeks, the patient was hospitalized due to manic episode with psychotic elements. The therapy was adjusted in accordance with world experience in the treatment of BAD during pregnancy. During hospitalization the dose of sodium valproate was reduced and the antipsychotic quetiapine was introduced into the therapy. The dose of quetiapine was titrated until the symptoms of the disease disappeared. The patient gave birth to a healthy baby girl by C-section. So far she has not been hospitalized. The pediatrician`s data indicate normal psychophysical development of the girl. Conclusion: Mental illness before and during pregnancy is a risk factor both for the mother and her newborn. Therefore, careful monitoring of pregnancy, as well as prescribing adequate psychopharmacotherapy with the least possible consequences for the mother and her child is a special challenge, but also a doctor`s duty.
Keywords
bipolar affective disorder; pregnancy; psychotropic drugs; relapse; teratogens
Hrčak ID:
251277
URI
Publication date:
1.3.2021.
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