Sharma Anjali, Thakur Manish Roshan, Prasad Shiv
Department of Psychiatry, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi, India.
Ind Psychiatry J. 2025 May-Aug;34(2):345-347. doi: 10.4103/ipj.ipj_185_24. Epub 2025 Jul 18.
This text discusses a case report of a pregnant anemic female in her second trimester with a diagnosis of bipolar depression and comorbid obsessive compulsive disorder (OCD). Managing both mood stabilization and obsessive compulsive symptoms simultaneously in a pregnant female presents a real challenge, especially considering that serotonin reuptake inhibitors (SSRI), the first-line treatment for OCD, can induce manic or mixed mood states in bipolar disorder patients. This case is unique in view of limited options left with pregnancy in place. Lamotrigine was chosen as an agent and was introduced in this patient which is rated as FDA pregnancy risk category C which amounts to risk cannot be ruled out (human data lacking, animal studies positive or not done). Patient responded well and maintained well on monotherapy of lamotrigine and showed significant improvement in both symptoms of depression and OCD. USG-level II examination shows no abnormality on repeated scans.
本文讨论了一例孕中期贫血女性的病例报告,该女性被诊断为双相抑郁症并伴有强迫症(OCD)。在孕期女性中同时管理情绪稳定和强迫症状是一项真正的挑战,特别是考虑到强迫症的一线治疗药物5-羟色胺再摄取抑制剂(SSRI)可在双相情感障碍患者中诱发躁狂或混合情绪状态。鉴于孕期可选择的治疗方法有限,该病例具有独特性。选择拉莫三嗪作为治疗药物并应用于该患者,其被美国食品药品监督管理局(FDA)列为妊娠风险C类药物,即不能排除风险(缺乏人类数据,动物研究结果为阳性或未开展)。患者对拉莫三嗪单一疗法反应良好且维持效果良好,抑郁和强迫症症状均有显著改善。超声二级检查显示多次扫描均无异常。