Susan is a 40-year-old obese, married, white female with a 24-year history She has had over 30 psychiatric hospitalizations, twosuicide attempts and has been previously treated with nine conventionalantipsychotics. She was started on Olanzapine 20 mg/day over the next sixweeks due to persistent symptoms. During the next 12 months, Susan beganpart-time work and enrolled in an adult education class. After one year,Susan and her husband approached the treatment team about having a baby. The couple had long wanted a child and received counseling regarding therisks and benefits of antipsychotic therapy during pregnancy.Fifteen months after beginning Olanzapine treatment, Susan becamepregnant and the couple decided to maintain olanzapine throughout thepregnancy. After one month Susan’s Olanzapine was decreased to 15 mg/dayand was maintained at that dosage throughout the pregnancy. Complicationsincluded pregnancy-related hypertension at 24 weeks, gestational diabetesat 26 weeks and preeclampsia at 29 weeks. By delivery she had gained 79pounds. Susan was hospitalized and a cesarean section was performed. At30 weeks, a viable, female infant was delivered. Susan did wellpost-operativelyAlthough her obstetrical team did not attribute her difficulties toOlanzapine treatment, the possible contribution of the medication to herpregnancy complications cannot be ruled out....
