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Unexpected depletion in plasma choline and phosphatidylcholine concentrations in a pregnant woman with bipolar affective disorder being treated with lithuim, haloperidol and benztropine: a case report

Maxine Gossell-Williams1*, Horace Fletcher2 and Steven H Zeisel3

Author Affiliations

1 Department of Basic Medical Sciences, University of the West Indies, Jamaica

2 Department of Obstetrics, Gynaecology and Child Health, University of The West Indies, Jamaica

3 Department of Nutrition, School of Public Health and School of Medicine University of North Carolina at Chapel Hill, NC 27599, USA

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Journal of Medical Case Reports 2008, 2:55  doi:10.1186/1752-1947-2-55

Published: 20 February 2008



Patients with bipolar affective disorder can be effectively managed with pharmacological intervention. This case report describes a pregnant woman with a ten-year history of bipolar affective disorder that was being treated with lithium, haloperidol and benztropine.

Case presentation

The patient had a normal pregnancy, but developed an elevated blood pressure and started to lose weight at 36 weeks of gestation. During pregnancy, plasma concentrations of choline and phosphatidylcholine are increased to meet the demands of the foetus. However, our findings in this case included depletion of plasma choline and phosphatidylcholine concentrations. Other unusual outcomes included low placental weight and low infant birth weight.


This report suggests that the pharmacological management of this patient could possibly account for the findings.