Reference no: EM133755041

Question

HPI: TZ is a 26-year-old married woman who suffers from bipolar disorder and is well maintained on mood stabilizing medications. At a routine follow-up appointment, she tells you that she and her husband are considering starting a family. She was first diagnosed with bipolar affective disorder when she presented with a manic episode at age 19. She was originally stabilized on a combination of an antipsychotic haloperidol and lithium. After taking lithium for 2 years her mood stabilizer was changed to valproic acid, as she was complaining of intolerable side effects. She has been hospitalized twice for manic episodes and treated as an outpatient for depression. She has never abused substances and does not use tobacco products. She has never been suicidal. She has a family history of bipolar disorder and major depression. She graduated from college and works as a dental hygienist. She lives in a rented apartment with her husband of 2 years, who works as a mechanic. She is taking prenatal vitamins and valproic acid 750 mg by mouth twice daily.

What are your concerns about medications should this patient become pregnant.