Pharmacological management of borderline personality disorder in a pregnant woman with a previous history of alcohol addiction: a case report.

The clinical utilization of psychotropic medications in pregnant women represents a significant challenge. Indeed, the risks of untreated severe mental disorders, particularly when complicated by substance-related and addictive disorders, must be carefully balanced against the potential teratogenic risks of pharmacological treatment. In this case, an alcohol addict, diagnosed with borderline personality disorder was treated successfully with several classes of psychotropic agents during the first trimester. In September 2014, while taking trazodone, lorazepam, quetiapine, mirtazapine, and flurazepam, this patient became aware that she was pregnant. After a perinatal psychiatrist consultation requested four months later, trazodone and flurazepam were progressively suspended and daily doses of lorazepam and quetiapine were lowered gradually. Mirtazapine dose remained unchanged. Apart from a mild gastro-esophageal reflux disease, birth outcome was normal.