CASE REPORT: BIPOLAR DISORDER AND ADVERSE EFFECTS

Abstract

Introduction: The management of patients diagnosed with Bipolar Disorder (BD) using mood stabilizers presents significant therapeutic challenges. Although lithium is effective in controlling BD, it is associated with severe adverse effects during chronic use, particularly nephrotoxicity. Valproic acid emerges as a therapeutic alternative for lithium-intolerant patients; however, its use can trigger rare but serious complications, such as drug-induced pancreatitis. Objective: To report the case of a female patient with bipolar disorder who developed severe adverse effects from the prescribed pharmacotherapy, and to conduct a literature review on the adverse effects of these medications, monitoring indications, and potential management strategies. Methodology: This is a case report supplemented by a narrative literature review, based on a retrospective analysis of the electronic medical records of a patient treated at the Psychiatry Outpatient Clinic of the Hospital de Base, Faculdade de Medicina de São José do Rio Preto, linked to the Department of Neurological Sciences, Psychiatry, and Medical Psychology of FAMERP. Results: A 55-year-old female patient diagnosed with BD at age 14. The patient achieved clinical stability at age 22 with lithium carbonate (600 mg/day) but developed nephropathy attributable to prolonged lithium therapy at age 48. Conclusion: This case illustrates the therapeutic dilemma between efficacy and safety in the treatment of BD, reinforcing the need for rigorous monitoring and a multidisciplinary approach.