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Treatment-resistant schizophrenia with high-risk pregnancy: Challenges in management

1 Department of Psychiatry, TNMC and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
2 Department of Psychiatry, PCMC's PGI, YCM Hospital, Pune, Maharashtra, India
3 Department of Psychiatry, BJGMC and SGH, Pune, Maharashtra, India, India

Correspondence Address:
Prerna Balkrishen Khar,
104, Magic Carpet CHS, Juhu Verosova Link Road, Andheri West, Mumbai - 400 053, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aip.aip_76_20

Managing a severe treatment-resistant psychiatric illness in the context of pregnancy has always been a challenge for psychiatrists, especially with a comorbid medical illness. We present a case of an elderly primigravida having schizophrenia of 22 years, with high-risk pregnancy, who suffered from an acute psychotic exacerbation during pregnancy. She was managed with clozapine, aripiprazole, and amisulpiride, after a failed trial of olanzapine and electroconvulsive therapy. This case highlights the challenges in managing an elderly primigravida with comorbid gestational diabetes mellitus and fibroid who required prolonged hospitalization throughout her pregnancy. A strong liaison with an obstetrician goes a long way in ensuring smooth management.

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