Abstract
Background: Postpartum psychosis (PPP) is a psychiatric emergency that generally warrants acute inpatient care. PPP is marked by the sudden onset of
affective and psychotic symptoms with a rapid deterioration in mental state. Evidence suggests that PPP is a discrete disorder on the bipolar disorder
spectrum with a distinct treatment profile and prognosis.
Methods: We conducted a PubMed database search for various terms involving PPP and its treatment and included peer-reviewed articles published
in English.
Objective: To provide a treatment algorithm for the management of PPP based on available evidence.
Results: Pharmacological therapy is the mainstay of PPP management in the acute phase. Evidence points to a combination of antipsychotics and
lithium in the acute treatment of PPP. Electroconvulsive therapy can offer a rapid treatment response where required. Lithium appears to have the
best evidence for relapse prevention and prophylaxis in PPP. Psychoeducation is essential and psychosocial interventions used in bipolar disorder may
be effective in PPP.
Conclusion: Early detection and prompt treatment with antipsychotics and lithium, followed by maintenance treatment with lithium, is associated
with a favourable prognosis in PPP.
affective and psychotic symptoms with a rapid deterioration in mental state. Evidence suggests that PPP is a discrete disorder on the bipolar disorder
spectrum with a distinct treatment profile and prognosis.
Methods: We conducted a PubMed database search for various terms involving PPP and its treatment and included peer-reviewed articles published
in English.
Objective: To provide a treatment algorithm for the management of PPP based on available evidence.
Results: Pharmacological therapy is the mainstay of PPP management in the acute phase. Evidence points to a combination of antipsychotics and
lithium in the acute treatment of PPP. Electroconvulsive therapy can offer a rapid treatment response where required. Lithium appears to have the
best evidence for relapse prevention and prophylaxis in PPP. Psychoeducation is essential and psychosocial interventions used in bipolar disorder may
be effective in PPP.
Conclusion: Early detection and prompt treatment with antipsychotics and lithium, followed by maintenance treatment with lithium, is associated
with a favourable prognosis in PPP.
| Original language | English |
|---|---|
| Pages (from-to) | 960-970 |
| Number of pages | 11 |
| Journal | Journal of psychopharmacology (Oxford, England) |
| Volume | 37 |
| Issue number | 10 |
| Early online date | 29 Jul 2023 |
| DOIs | |
| Publication status | Published - Oct 2023 |
Keywords
- Postpartum psychosis, prophylaxis, treatment