Intellectual disability is a known condition, but psychosis and its extension in functional areas of life, with episodes of seizures in between, make the case complex and leave clinicians with a limited choice of treatment and unpredictable outcomes. We present the case of a 20-year-old female with intellectual disability, episodes of seizures, and pattern of psychosis, with its course describing the perplexity of the treatment in the area of its outcome predictability, which also highlights the lack of a structured approach for clinicians' guidance in managing it as a multidisciplinary field.