Navigating the Complexity of a Bipolar Pregnant Patient With Multiple Comorbidities
Paula Traugott1, Adriana Medina2, Jonathan M Parker3
1Medicine, University of Buenos Aires, Buenos Aires, ARG.
Cureus
|February 2, 2024
Summary
This case study details managing a pregnant woman with bipolar I disorder, epilepsy, and substance use disorder. Comprehensive inpatient treatment ensured safe delivery and optimized outcomes for mother and child.
Area of Science:
- Neuroscience
- Psychiatry
- Obstetrics
Background:
- Bipolar I disorder (BDI) involves manic episodes.
- Epilepsy and psychogenic nonepileptic seizures (PNES) are neurological disorders.
- Substance use disorder (SUD) is characterized by impaired control and addictive behaviors.
Observation:
- A 20-year-old pregnant woman presented with BDI, epilepsy, PNES, and polyvalent SUD.
- She required multiple involuntary holds during pregnancy.
- Inpatient psychiatric treatment was court-ordered at 30 weeks' gestation due to risks to mother and fetus.
Findings:
- Comprehensive inpatient treatment included medications such as risperidone, levetiracetam, lacosamide, haloperidol, diphenhydramine, lorazepam, and clozapine.
- A detailed discharge plan was developed for both mother and child.
- The case highlights successful management of complex comorbid conditions during pregnancy.
Implications:
- This case contributes to understanding the management of pregnant patients with complex psychiatric and neurological comorbidities.
- Optimizing maternal and fetal health outcomes requires integrated, multidisciplinary care.
- Effective treatment strategies can improve prognosis for high-risk pregnancies involving severe mental illness and substance use.
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