Pharmacological and Non-pharmacological Management of Bipolar Disorder with Comorbid Huntington's Disease: A Case Report
Keywords:Bipolar Disorder, Electroconvulsive therapy, Huntington’s Disease, Tourette syndrome, Transcranial Magnetic Stimulation
Bipolar disorder and Huntington's disease are chronic, debilitating conditions that may present during early to middle adulthood. While reports exist on managing each condition separately, data on their comorbidity is limited. We describe a case of successfully treating a patient with comorbid bipolar disorder and Huntington's disease. A 36-year-old male presented with mania, psychosis and involuntary movements. He was diagnosed with bipolar disorder type I and Huntington's disease based on the clinical features and family history. He was treated with quetiapine, valproate, lorazepam, lithium, ECT and TMS. Investigations including blood tests, CT scan and psychiatric assessment were performed. The patient's symptoms showed some improvement with treatment. However, optimization of pharmacotherapy and use of ECT/TMS as maintenance therapy were recommended to achieve better control of bipolar symptoms. Involuntary movements and gait disturbance were attributed to Huntington's disease. This case highlights the diagnostic and management challenges in comorbid bipolar disorder and Huntington's disease. Despite pharmacological and non-pharmacological treatments, coordinated multidisciplinary care should be provided. Insights from this case report may help to optimize the management in similar patients.
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