title: Challenges in managing a mother with a dual diagnosis of peripartum cardiomyopathy and paranoid schizophrenia - a case report.
abstract: BACKGROUND
  Psychotic illness has a low incidence in the puerperal period. Peripartum cardiomyopathy as a complication of pregnancy is also rare.
  
  
  METHODS
  We report a case where the above two conditions occurred simultaneously in a patient and posed significant difficulties in the clinical management. She was diagnosed as having paranoid schizophrenia and peripartum cardiomyopathy. Many of the antipsychotics were contraindicated, and electroconvulsive therapy could not be administered due to the added risks involved with regard to anesthesia. She was therefore managed with clonazepam and olanzapine.
  
  
  CONCLUSIONS
  This case highlights the challenges in a patient with a psychiatric illness presenting with comorbid physical illness.
authors.affiliation: University Psychiatry Unit, Colombo South Teaching Hospital, Kalubowila, Sri Lanka.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Weerasundera
authors.forename: Jegan
authors.initials: J
authors.lastname: Yogaratnam
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000150:complications*; D002998:Clonazepam / Q000627:therapeutic use*; D019468:Disease Management; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use*; D006801:Humans; D000077152:Olanzapine; D058725:Peripartum Period; D011644:Puerperal Disorders / Q000188:drug therapy*; D012563:Schizophrenia, Paranoid / Q000150:complications / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D018757:GABA Modulators; D001569:Benzodiazepines; D002998:Clonazepam; D000077152:Olanzapine
keywords: Management challenges; Peripartum cardiomyopathy; Schizophrenia