Materiały źródłowe

• #1 Recognizing and Managing Postpartum Psychosis: A Clinical Guide for Obstetric Providers

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6174883/

  Postpartum psychosis is at once the most dangerous and the least understood of perinatal psychiatric disorders. It affects 1-2 per 1,000 women and constitutes a true psychiatric emergency, one that requires immediate hospitalization and treatment. […] Postpartum psychosis is a psychiatric emergency that requires inpatient hospitalization. In much of the developed world, that hospitalization can take place in a dedicated mother-baby psychiatric unit, the type of facility that is deemed best practice in many countries. […] Treatment requires hospitalization and aggressive pharmacological management.

• #1 Postpartum Psychosis: Symptoms, Treatment and More

  https://www.healthline.com/health/parenting/postpartum-psychosis

  Postpartum psychosis is a medical emergency. A person should call 911 and seek treatment at an emergency room, or have someone take them to an emergency room or crisis center. Often, a woman will receive treatment at an inpatient center for at least a few days until her mood is stabilized and she is no longer at risk for harming herself or her baby. […] Treatments during the psychotic episode include medications to reduce depression, stabilize moods, and reduce psychosis. Examples include: […] Antipsychotics: These medications reduce the incidence of hallucinations. Examples include risperidone (Risperdal), olanzapine (Zyprexa), ziprasidone (Geodon), and aripiprazole (Abilify). […] Mood stabilizers: These medications reduce manic episodes. Examples include lithium (Lithobid), carbamazepine (Tegretol), lamotrigine (Lamictal), and divalproex sodium (Depakote).

• #1 Treatment of postpartum psychosis in breastfeeding females in: Mental Health Clinician Volume 14: Issue 5 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/14/5/article-p277.xml?searchresult=1

  Lithium is another therapeutic option for PPP. The ACOG does not provide specific dosing recommendations for lithium treatment; one source recommends a target level of 0.8-1.2 mmol/L for acute stabilization and a target level 0.6-0.8 mmol/L for relapse prevention. Currently brexanolone and zuranolone are recommended treatments for postpartum depression; however, there are no studies that examine the efficacy of these medications for treatment of PPP. From a nonpharmacological standpoint, ECT has also shown benefits in refractory cases and for patients with catatonia or severe depression symptoms. Additionally, foregoing breastfeeding overnight as part of sleep preservation can also be helpful in the early phase of treatment and stabilization. If treated appropriately and quickly, the ACOG guidelines suggest full remission of PPP can be achieved when the mother is approximately 2 months postpartum.

• #1 Postpartum psychosis – NHS

  https://www.nhs.uk/mental-health/conditions/post-partum-psychosis/

  Electroconvulsive therapy (ECT) is sometimes recommended if all other treatment options have failed, or when the situation is thought to be life threatening. […] As you move forward with your recovery, you may benefit from seeing a therapist for cognitive behavioural therapy (CBT). CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. […] With treatment and the right support, most people with postpartum psychosis do make a full recovery.

• #1

  https://link.springer.com/article/10.1007/s00737-020-01025-z

  The importance of involving the family by providing information and fostering feelings of security and hope has also been reported by professionals working with women experiencing postpartum psychosis. […] Psychological support for families was needed to help develop family members understanding of postpartum psychosis, enhance their coping with the additional stress and enable them to know how to respond and cope with fear around relapse. […] The review reveals the complexity of recovery from postpartum psychosis and the need for intervention to be incorporated into a longer term recovery plan, which includes psychological and psychosocial needs alongside medical management.

• #1 Postpartum psychosis

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis

  During the worst part of your postpartum psychosis you will need practical help to care for your baby and also help to bond with your baby. Mother and Baby Unit (MBU) staff are trained to support you with every aspect of caring for your baby. If you do not go to an MBU, health visitors and mental health professionals can help and support you at home. […] You will usually need to have care from a community perinatal mental health service until you fully recover. This team can advise you about treatment and support for you and your family. You may also have a general adult mental health team. […] If your partner has postpartum psychosis, it can be very distressing for you even frightening or shocking. Do ask for help when your partner first has symptoms. This is particularly important if she does not understand that she is ill.

• #1 Postpartum Psychosis: Symptoms, Treatment and More

  https://www.healthline.com/health/parenting/postpartum-psychosis

  If a woman doesn’t respond well to medicines or needs further treatment, electroconvulsive shock therapy (ECT) is often very effective. This therapy involves delivering a controlled amount of electromagnetic stimulation to your brain. […] The most acute symptoms of postpartum psychosis can last anywhere from two to 12 weeks. Some women may need longer to recover, from six to 12 months. Even after the major psychosis symptoms go away, women may have feelings of depression and/or anxiety. […] Sometimes a doctor will prescribe a mood stabilizer like lithium for a woman to take after giving birth. This could potentially prevent postpartum psychosis.

• #1 Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00236-2

  Our primary recommendation for antipsychotic treatment was haloperidol at 26 mg/day. Patients who experienced side effects were switched to an atypical antipsychotic. […] After complete remission of symptoms, all women were advised to taper benzodiazepines to discontinuation. Women receiving antipsychotic monotherapy were advised to continue this treatment as maintenance therapy until nine months postpartum. Women who achieved clinical remission using both antipsychotics and lithium were advised to gradually taper off antipsychotic treatment, with maintenance lithium monotherapy until nine months postpartum. […] Understanding who is at risk of a mood or psychotic disorder during follow-up, and whose vulnerability is limited to the postpartum period, is particularly important in guiding treatment decisions including long-term pharmacotherapy. Unfortunately, no biomarkers are currently available to help guide these decisions. In clinical practice, this means that long-term monitoring is warranted for everyone with postpartum psychosis.

• #1 Understanding postpartum psychosis: From course to treatment – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/2021-reproductive-psychiatry/

  Dr. Lee S. Cohen, Director of the Ammon-Pinizzotto Center for Women’s Mental Health at Massachusetts General Hospital, recently shared his insights on diagnosing and treating postpartum psychosis with Ob.Gyn News on January 30th, 2020. […] From a clinical point of view, women with postpartum psychosis typically are hospitalized, given that this is both a psychiatric and potential obstetrical emergency. […] Clinical wisdom has dictated that, given the dramatic symptoms with which these patients present, most patients are treated with lithium and an antipsychotic medication as if they have a manic-like psychosis. […] Given that the risk for recurrent postpartum psychosis is so great (70%-90%), women with histories of postpartum psychosis invariably are prophylaxed with mood stabilizer prior to delivery in a subsequent pregnancy.

• #1 Psychological interventions for managing postpartum psychosis: a qualitative analysis of women’s and family members’ experiences and preferences | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-019-2378-y

  The emotional impact of postpartum psychosis and associated sense of loss remained with women for many years. […] Psychological interventions were sought at this time and are recommended to facilitate this adjustment process. Finally, as women seek to integrate their experiences, they may benefit from support to maintain their wellbeing, manage fear of relapse and plan for their future. Psychological approaches deemed useful are those incorporating acceptance or compassion based techniques, family interventions, trauma work and relapse prevention planning.

• #1 Postpartum Psychosis – A Comprehensive Review

  https://psychscenehub.com/psychinsights/postpartum-psychosis-review/

  The main pharmacological agents used are benzodiazepines, antipsychotics and lithium. […] Antipsychotics are recommended for the acute treatment of manic and psychotic symptoms. […] Lithium is highly efficacious for the acute and maintenance treatment of postpartum psychosis. […] The 4 step approach was used in a study for acute and maintenance treatment of patients hospitalised four weeks after delivery for the first onset of psychosis. […] Non-pharmacological approaches include blue-light-blocking glasses, sleep hygiene interventions, support for the other parent, and specific feedback designed to improve the mother-baby interaction. […] Women with postpartum psychosis usually have one of two disease courses: isolated postpartum psychosis or postpartum psychosis as an expression of bipolar mood disorder with non-perinatal episodes.

• #1 Management of New Onset Psychosis in the Postpartum Period

  https://www.psychiatrist.com/jcp/new-onset-psychosis-in-the-postpartum-period/

  Postpartum psychosis is a psychiatric emergency. Immediate treatment with a combination of lithium, antipsychotics, and benzodiazepines has been demonstrated to be effective, and ECT may be required. […] Recommendations for long-term treatment and prevention of future episodes vary based on the patients psychiatric history, and a treatment plan should be made together with the patient based on her preferences, history of response, and the potential risks of treatment, as well as the patients desire to breastfeed.

• #2 Postpartum psychosis – NHS

  https://www.nhs.uk/mental-health/conditions/post-partum-psychosis/

  Postpartum psychosis is a serious mental health illness that can affect someone soon after having a baby. […] Postpartum psychosis is a serious mental illness that should be treated as a medical emergency. […] Treatment usually happens in hospital. Ideally, this would be with your baby in a specialist psychiatric unit called a mother and baby unit (MBU). But you may be admitted to a general psychiatric ward until an MBU is available. […] Most people with postpartum psychosis make a full recovery as long as they receive the right treatment. […] You may be prescribed 1 or more of the following: antipsychotics to help with manic and psychotic symptoms, such as delusions or hallucinations; mood stabilisers (for example, lithium) to stabilise your mood and prevent symptoms recurring; antidepressants to help ease symptoms if you have significant symptoms of depression and may be used alongside a mood stabiliser.

• #2 Postpartum Psychosis: Symptoms, Causes, Treatment

  https://www.mentalhealth.com/library/postpartum-psychosis-symptoms-causes-treatment

  Postpartum psychosis is a rare and severe mental health disorder that can occur after pregnancy. Symptoms vary from person to person and can be treated using medication and talking therapy. […] If someone is diagnosed with postpartum psychosis, they are usually taken to a mother and baby unit (MBU) so that the person with the diagnosis can be treated with their baby. In most cases, postpartum psychosis is treated with a combination of talking therapy and medication. It is most often treated in a hospital or other medical facility, i.e., MBU or psychiatric ward for the first few days. […] Common medications used to treat postpartum psychosis are listed below and are used on their own or in combination with each other: Antipsychotics help to treat psychotic and manic symptoms, including hallucinations and delusions. Examples include risperidone, aripiprazole, olanzapine, and ziprasidone. Mood stabilizers include medications such as lithium to calm extreme manic and depressed moods. Other examples include lamotrigine, divalproex sodium, and carbamazepine. Antidepressants, such as SSRIs, can be used alongside mood stabilizers to treat symptoms of depression and help to support an improved night’s sleep.

• #2 Postpartum psychosis | Pregnancy Birth and Baby

  https://www.pregnancybirthbaby.org.au/postpartum-psychosis

  Electroconvulsive therapy is a process that stimulates nerve cells in the brain with an electric current to treat severe symptoms of mania, psychosis and severe depression. You might need this if your symptoms are severe. […] Psychological therapies, such as cognitive behaviour therapy (CBT) can help you to develop coping strategies as you recover. […] Recovery can be slow and take time. It’s important to minimise stress and try to sleep well. Consider limiting the number of visitors you have, especially as the beginning, as too many visitors can be overwhelming. […] Counselling and support for your partner and support people is also important.

• #2 Postpartum Psychosis – A Comprehensive Review

  https://psychscenehub.com/psychinsights/postpartum-psychosis-review/

  The main pharmacological agents used are benzodiazepines, antipsychotics and lithium. […] Antipsychotics are recommended for the acute treatment of manic and psychotic symptoms. […] Lithium is highly efficacious for the acute and maintenance treatment of postpartum psychosis. […] The 4 step approach was used in a study for acute and maintenance treatment of patients hospitalised four weeks after delivery for the first onset of psychosis. […] Non-pharmacological approaches include blue-light-blocking glasses, sleep hygiene interventions, support for the other parent, and specific feedback designed to improve the mother-baby interaction. […] Women with postpartum psychosis usually have one of two disease courses: isolated postpartum psychosis or postpartum psychosis as an expression of bipolar mood disorder with non-perinatal episodes.

• #2 Postpartum psychosis

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis

  It can take 6 -12 months or more to recover from postpartum psychosis. The most severe symptoms tend to last 2 to 12 weeks. You are likely to recover fully, but you may have another episode in the future. […] Many women who have had postpartum psychosis go on to have more children, but there is a high risk of having another episode. About 1 in 2 (50%) women who have had postpartum psychosis will have this again after the birth of another baby. With the right care, if you have another episode, you should be able to get help quickly.

• #2 Postpartum Psychosis – PsychDB

  https://www.psychdb.com/psychosis/z-postpartum

  PPP is considered a psychiatric emergency, and requires immediate hospitalization and treatment. […] Various effective treatments include antipsychotics, benzodiazepines, mood stabilizers (in particular lithium), hormones, propranolol, and electroconvulsive therapy (ECT). […] Although pharmacological management is the main treatment, psychosocial supports including in particular sleep hygiene and general family and caregiver support is important. […] Treatment Recommendations for Acute Postpartum Psychosis: Step 1 Benzodiazepine (lorazepam 0.5-1.5 mg TID) Step 2 Antipsychotic (high potency preferred, haloperidol 2-6 mg or olanzapine 10-15 mg) Step 3 Lithium (to achieve serum level of 0.8-1.2 mmol/L) Step 4 Taper benzodiazepine and antipsychotic once symptom remission achieved Maintenance Continue lithium monotherapy for 9 months (can lower to achieve serum level of 0.6-0.8 after symptom remission if severe side effects) For future pregnancies, begin prophylactic lithium monotherapy during pregnancy or immediately postpartum.

• #2 Postpartum psychosis: a practical management guide for obstetricians – O&G Magazine

  https://www.ogmagazine.org.au/20/3-20/postpartum-psychosis-a-practical-management-guide-for-obstetricians/

  Once the woman is engaged with psychiatry, a sedating antipsychotic, such as quetiapine (Seroquel), will need to be commenced. […] Response to the antipsychotic needs close monitoring and, all going well, reduction and cessation after six months (if this is the womans first episode of psychosis) can be undertaken. […] It is important to explain the difference between postnatal depression and postpartum psychosis. […] Women and their families need to learn about the early signs of relapse of psychosis, most commonly: insomnia, independent of babys waking; racing thoughts; erratic mood shift or severe anxiety; distractibility; or unfounded preoccupation with the baby or familys welfare. […] Subsequent pregnancy is not contraindicated, but best deferred until the woman has been free of symptoms for over a year. […] It is important to devise a clear mental healthcare plan with the woman and her family for any subsequent pregnancy.

• #2 Postnatal psychosis | Mental Health Foundation

  https://mentalhealth.org.nz/conditions/condition/postnatal-psychosis

  Postnatal psychosis often requires treatment with antipsychotic drugs, mood stabilisers and/or antidepressants. These are usually prescribed by a specialist psychiatrist. The actual medication you are prescribed will depend on how severe your condition is and how you are feeding your baby. […] Your doctor will recommend a mix of treatment options that best suit you. This will usually include medication as well as talking therapy. […] With early recognition and treatment, and the right support, you will be able to reduce the risk and make a good recovery if you do experience postnatal psychosis. […] A health professional works with you, and your family/whānau, to provide information about the condition, its treatment, and how to support recovery. Central to this approach is that family/whānau, along with the person experiencing the condition, are critical members of the treatment team. […] It is also really important to look after your physical wellbeing. Make sure you get an annual check-up with your doctor, and do what you can to reduce stress, get enough sleep, eat a balanced diet and exercise. Being in good physical health will also help your mental health.

• #2 Postpartum Psychosis: Updates and Clinical Issues

  https://www.psychiatrictimes.com/view/postpartum-psychosis-updates-and-clinical-issues

  Postpartum psychosis can be conceptualized as a psychiatric manifestation with abrupt onset following childbirth, an event filled with major biopsychosocial changes. […] Treatment is similar to that of nonpostpartum psychosis. Antipsychotics, mood stabilizers, and benzodiazepines are the interventions of choice. Treatment choice is also dictated by possible comorbidities, response to previous treatments, drug tolerability, the patients ability to cooperate, and whether the patient is breast-feeding. […] Lithium is an important medication for the management of postpartum psychosis. Monitoring of lithium levels, thyroid and renal function, and adequate hydration are standards of care when using lithium. […] Valproic acid or carbamazepine may be used to manage postpartum psychosis. […] Atypical antipsychotics are often first-line choices for psychosis and mania because of their tolerability.

• #3 Postpartum Psychosis: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24152-postpartum-psychosis

  Postpartum psychosis is treatable, and early treatment increases the odds of a good outcome. […] Because PPP is a mental health emergency, people with this condition need inpatient mental healthcare. This kind of care means trained medical professionals are with them at all times to make sure theyre safe and as comfortable as possible. […] The possible treatment methods include: Medications, Electroconvulsive therapy (ECT). […] Many different medication types can help PPP. The types include: Antipsychotic medications, Mood stabilizers, Antiseizure drugs, Lithium. […] Electroconvulsive therapy (ECT) is a safe and highly effective method for treating conditions that involve psychosis. This treatment uses a mild electrical current, passed through your brain, to induce a mild seizure. […] With treatment, this condition is reversible and many people who have it go on to have children in the future without a recurrence of PPP.

• #3 Postpartum psychosis: a practical management guide for obstetricians – O&G Magazine

  https://www.ogmagazine.org.au/20/3-20/postpartum-psychosis-a-practical-management-guide-for-obstetricians/

  Once the woman is engaged with psychiatry, a sedating antipsychotic, such as quetiapine (Seroquel), will need to be commenced. […] Response to the antipsychotic needs close monitoring and, all going well, reduction and cessation after six months (if this is the womans first episode of psychosis) can be undertaken. […] It is important to explain the difference between postnatal depression and postpartum psychosis. […] Women and their families need to learn about the early signs of relapse of psychosis, most commonly: insomnia, independent of babys waking; racing thoughts; erratic mood shift or severe anxiety; distractibility; or unfounded preoccupation with the baby or familys welfare. […] Subsequent pregnancy is not contraindicated, but best deferred until the woman has been free of symptoms for over a year. […] It is important to devise a clear mental healthcare plan with the woman and her family for any subsequent pregnancy.

• #3 What Is A Postpartum Psychotic Episode? Mental Health Care For Postpartum Psychosis | BetterHelp

  https://www.betterhelp.com/advice/psychosis/what-is-a-postpartum-psychotic-episode-mental-health-care-for-postpartum-psychosis

  Postpartum psychosis is a serious mental illness characterized by a disconnection from reality, which can significantly impact the life of a parent. […] Treatment often involves medication and psychotherapy. In some cases, brain stimulation therapy may also be utilized. […] Treatment for a postpartum psychotic episode typically involves the following. […] Various psychiatric medications are recommended for those living with postpartum psychosis. Commonly, antipsychotic medications are used to help alleviate symptoms like hallucinations and delusions. Mood stabilizers can often help address the emotional challenges of PPP. […] Psychotherapy is often recommended as an adjunct treatment to hospitalization and medication. Therapy can provide a birthing parent with emotional support as they navigate the mood swings of a psychotic episode. […] Electroconvulsive therapy (ECT) is considered a safe and effective treatment for symptoms of a postpartum psychotic episode that have not responded to other modalities.

• #3 How Mother-and-Baby Units Treat Postpartum Psychosis – The New York Times

  https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-health-pregnancy-women.html

  Experts say that the longer stays at mother-and-baby units help to ensure that women are not discharged before they’re ready, which can easily happen — symptoms of postpartum psychosis are known to wax and wane. […] “You can’t get better by yourself and then get thrown into motherhood, which is what triggered you in the first place,” said Ruth Hanna, who stayed at a mother-and-baby unit in Glasgow in 2020. […] There, doctors diagnosed Ms. Hanna with postpartum psychosis. […] The nurses filmed Ms. Hanna doing basic tasks such as changing her son’s diaper, and watched the footage back together with her. They wanted to show her that she was capable of caring for her son. […] “Recovery doesn’t stop on leaving here,” Dr. Coyle said. […] It was around that time that Ms. Hardie was diagnosed with bipolar disorder, which is closely connected with postpartum psychosis. After several more weeks and some new treatment, Ms. Hardie finally felt like herself again, and was able to go home for good. […] Studies show that with proper treatment, almost all women will recover from postpartum psychosis.

• #4 Postpartum psychosis – COPE

  https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/postpartum-psychosis/

  Postpartum psychosis is a very serious mental health condition that requires urgent attention and treatment. […] It is very important that postpartum psychosis is identified and treatment sought urgently as the condition is very serious and places the mother at risk of harming herself, the baby and/or other children due to its impacts on her thinking and behaviours. […] As postpartum psychosis is a serious mental health condition, it is very important to seek urgent and immediate professional help from a GP, mental health service or hospital emergency department so that timely and appropriate management can stabilise the woman’s energy, thinking, behaviour and moods. […] Treatment will almost always require admission to a psychiatric hospital. This will allow the woman to be in a safe environment where she can be closely monitored by health professionals.

• #5 Treatment of postpartum psychosis in breastfeeding females in: Mental Health Clinician Volume 14: Issue 5 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/14/5/article-p277.xml?searchresult=1

  The first priority of treatment should be ensuring the mother and child are safe; although not ideal, hospitalization of the mother suffering from PPP is pertinent. Additionally, it is important to avoid leaving the mother alone with the child as the infanticide rate of PPP ranges from 1% to 4.5%. For the treatment of PPP, the impacts of benzodiazepines, antipsychotics, lithium, and electroconvulsive therapy (ECT) have been studied. […] There is no specific clinical treatment guideline for PPP; however, the American College of Obstetricians and Gynecologists (ACOG) provides a few recommendations in their (2023) guideline. Specifically, it is recommended that a psychiatrist provide assessment and treatment for the patient with PPP. Additionally, the ACOG discourages the use of antidepressants for acute depression with psychosis, especially without the presence of appropriate mood stabilization. Further, initiation of a sedative antipsychotic medication, such as olanzapine or haloperidol, with short-acting benzodiazepines, such as lorazepam, is the first-line recommended treatment for PPP during the acute stabilization period while awaiting assessment by a psychiatrist.

• #6 Postpartum Psychosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544304/

  Postpartum psychosis is an acute illness of multifactorial origin and is considered a psychiatric emergency. […] This activity also outlines the role of interprofessional team members in increasing awareness and decreasing latency between onset and diagnosis of this condition to improve treatment outcomes in patients experiencing postpartum psychosis. […] Explain the pharmacological and nonpharmacological treatment options and the indications for immediate admission to the hospital in a patient with postpartum psychosis. […] Postpartum psychosis usually has a sudden onset but is a brief and limited illness that responds rapidly to treatment. Mothers who are at risk for harm to themselves or the baby require immediate hospitalization. […] Once organic causes have been ruled out, medications to control acute psychosis may be started. These include mood stabilizers, atypical antipsychotics, and antiepileptic drugs.

• #7 Recognizing and Managing Postpartum Psychosis: A Clinical Guide for Obstetric Providers

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6174883/

  Postpartum psychosis is at once the most dangerous and the least understood of perinatal psychiatric disorders. It affects 1-2 per 1,000 women and constitutes a true psychiatric emergency, one that requires immediate hospitalization and treatment. […] Postpartum psychosis is a psychiatric emergency that requires inpatient hospitalization. In much of the developed world, that hospitalization can take place in a dedicated mother-baby psychiatric unit, the type of facility that is deemed best practice in many countries. […] Treatment requires hospitalization and aggressive pharmacological management.

• #8 Postpartum psychosis – COPE

  https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/postpartum-psychosis/

  Postpartum psychosis is a very serious mental health condition that requires urgent attention and treatment. […] It is very important that postpartum psychosis is identified and treatment sought urgently as the condition is very serious and places the mother at risk of harming herself, the baby and/or other children due to its impacts on her thinking and behaviours. […] As postpartum psychosis is a serious mental health condition, it is very important to seek urgent and immediate professional help from a GP, mental health service or hospital emergency department so that timely and appropriate management can stabilise the woman’s energy, thinking, behaviour and moods. […] Treatment will almost always require admission to a psychiatric hospital. This will allow the woman to be in a safe environment where she can be closely monitored by health professionals.

• #9 Postpartum psychosis – NHS

  https://www.nhs.uk/mental-health/conditions/post-partum-psychosis/

  Postpartum psychosis is a serious mental health illness that can affect someone soon after having a baby. […] Postpartum psychosis is a serious mental illness that should be treated as a medical emergency. […] Treatment usually happens in hospital. Ideally, this would be with your baby in a specialist psychiatric unit called a mother and baby unit (MBU). But you may be admitted to a general psychiatric ward until an MBU is available. […] Most people with postpartum psychosis make a full recovery as long as they receive the right treatment. […] You may be prescribed 1 or more of the following: antipsychotics to help with manic and psychotic symptoms, such as delusions or hallucinations; mood stabilisers (for example, lithium) to stabilise your mood and prevent symptoms recurring; antidepressants to help ease symptoms if you have significant symptoms of depression and may be used alongside a mood stabiliser.

• #10 Postpartum Psychosis: What to Know About Symptoms and Treatment – The New York Times

  https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-pregnancy-what-symptoms-treatment.html

  Postpartum psychosis requires emergency care. With proper treatment, women can recover fully. One study of women with the diagnosis found that nearly all participants achieved remission. […] In the majority of cases, psychiatric hospitalization is required to protect the health of both the mother and the baby. […] Many experts consider mother-and-baby units (MBUs), which allow mothers and babies to remain together under careful supervision, the gold standard of care for postpartum psychosis. […] One study of mothers with severe postpartum psychosis who were admitted to an MBU — most of them involuntarily — found that all of them had improved by the time of discharge, and all left with custody of their child. […] One of the first goals of treatment in any type of facility is to help new mothers catch up on sleep, as doctors believe that sleep deprivation can trigger psychosis. Most women also receive medication, often a combination of benzodiazepines, antipsychotics and lithium. Research has shown that electroconvulsive therapy, or ECT, can effectively treat severe cases. […] Dr. Davis said there are three things she tells any woman experiencing postpartum psychosis: “You’re not alone, you’re not to blame, and with help you will get well.”

• #11 How Mother-and-Baby Units Treat Postpartum Psychosis – The New York Times

  https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-health-pregnancy-women.html

  Studies show that with proper treatment, almost all women will recover from postpartum psychosis. […] Most women with postpartum psychosis are not a risk to their children, Dr. Coyle said — if they get the right care. […] These specialized wards, now found in Britain, France, Australia and other parts of the world, provide psychiatric care for pregnant women from their third trimester through the first year after the birth — the period when women are more vulnerable to mental illnesses than at any other time in their lives. The goal is not just to help women recover in the short term, but also to let them build the confidence that they can care for their children safely when they return home. […] Women with postpartum psychosis also tend to stay for much longer — sometimes for months — in a mother-and-baby unit than they would in a general psychiatric ward.

• #12 How Mother-and-Baby Units Treat Postpartum Psychosis – The New York Times

  https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-health-pregnancy-women.html

  Experts say that the longer stays at mother-and-baby units help to ensure that women are not discharged before they’re ready, which can easily happen — symptoms of postpartum psychosis are known to wax and wane. […] “You can’t get better by yourself and then get thrown into motherhood, which is what triggered you in the first place,” said Ruth Hanna, who stayed at a mother-and-baby unit in Glasgow in 2020. […] There, doctors diagnosed Ms. Hanna with postpartum psychosis. […] The nurses filmed Ms. Hanna doing basic tasks such as changing her son’s diaper, and watched the footage back together with her. They wanted to show her that she was capable of caring for her son. […] “Recovery doesn’t stop on leaving here,” Dr. Coyle said. […] It was around that time that Ms. Hardie was diagnosed with bipolar disorder, which is closely connected with postpartum psychosis. After several more weeks and some new treatment, Ms. Hardie finally felt like herself again, and was able to go home for good. […] Studies show that with proper treatment, almost all women will recover from postpartum psychosis.

• #13 Management of New Onset Psychosis in the Postpartum Period

  https://www.psychiatrist.com/jcp/new-onset-psychosis-in-the-postpartum-period/

  In this article, we provide a synopsis of the clinical presentation and diagnosis of postpartum psychosis and review treatment and prevention strategies. […] Postpartum psychosis is managed as a psychiatric emergency as it is associated with an increased risk of suicide and potential risk to the infant. […] Inpatient psychiatric hospitalization is the recommended treatment setting due to risk of harm to mother and infant. Small treatment studies and case reports provide evidence for the use of lithium, antipsychotics, and electroconvulsive therapy (ECT). […] In this study, 98.4% of patients achieved remission within the first 3 steps of the algorithm. […] ECT is strongly considered in patients with catatonia and depression with psychotic features. […] While the patient is acutely psychotic, her contact with her infant may need to be limited due to risk for harm.

• #14 Postpartum psychosis – COPE

  https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/postpartum-psychosis/

  Medication is necessary for the treatment and management of postpartum psychosis to address the chemical imbalance that is leading to the range of extreme symptoms that the woman is likely to be experiencing. […] A specialist psychiatrist should be consulted when prescribing medications for postpartum psychosis. […] Mood stabilisers work to stabilise mood and help reduce the likelihood of the symptoms recurring (relapse). […] Antidepressants are used to treat the symptoms of depression that are part of the depression part of the disorder. […] Antipsychotics assist with both manic and psychotic symptoms such as delusions or hallucinations. […] Electroconvulsive Therapy (ECT) is a specialist treatment that may be included in the treatment of postpartum psychosis. […] There are safe and effective treatments for postpartum psychosis. Getting help as soon as possible can help reduce the impacts of this serious mental health condition on the mother, her partner, the infant and other members of the family.

• #15 Postpartum Psychosis: Education, Screening, and Treatment for Maternal and Infant Vitality – The Breathing Association

  https://breathingassociation.org/postpartum-psychosis-education-screening-and-treatment-for-maternal-and-infant-vitality/

  Postpartum psychosis is a mental health condition that occurs during pregnancy and the first year following birth. […] Timely screening and treatment are critical for optimal recovery. […] Although psychosis is a serious mental health condition, it can be treated. Treatment typically includes hospitalization, medication, and therapy. […] For those who experience postpartum psychosis to receive necessary treatment, there is a need for health care providers and birthworkers to receive adequate training on the breadth of perinatal mental health complications, as well as screening and referral processes.

• #16 Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00236-2

  Due to the high relative risk for suicide and infanticide, early recognition and adequate treatment of postpartum psychosis is crucial. With adequate treatment, nearly all women with postpartum psychosis achieve full remission, and a large proportion of patients achieve good functional recovery. […] In the absence of formal guidelines, treatment in clinical practice is typically based on the most prominent symptom dimensions. Benzodiazepines are used for insomnia and agitation, antipsychotics and mood stabilizers for psychotic and manic symptoms, and antidepressants for depressive symptoms. […] During admission, women with a first-onset postpartum psychosis were treated according to a standardized treatment algorithm. The first step in treatment involves benzodiazepines at bedtime for three days. The purpose of starting with an initial period of benzodiazepine monotherapy is to evaluate whether restoration of sleep results in clinical remission of manic and psychotic symptoms, as sleep loss has been considered an important etiological factor in postpartum psychosis. For patients whose manic or psychotic symptoms persist after a few days of benzodiazepine monotherapy, the next recommended step involves antipsychotic medication.

• #17 Postpartum Psychosis – PsychDB

  https://www.psychdb.com/psychosis/z-postpartum

  PPP is considered a psychiatric emergency, and requires immediate hospitalization and treatment. […] Various effective treatments include antipsychotics, benzodiazepines, mood stabilizers (in particular lithium), hormones, propranolol, and electroconvulsive therapy (ECT). […] Although pharmacological management is the main treatment, psychosocial supports including in particular sleep hygiene and general family and caregiver support is important. […] Treatment Recommendations for Acute Postpartum Psychosis: Step 1 Benzodiazepine (lorazepam 0.5-1.5 mg TID) Step 2 Antipsychotic (high potency preferred, haloperidol 2-6 mg or olanzapine 10-15 mg) Step 3 Lithium (to achieve serum level of 0.8-1.2 mmol/L) Step 4 Taper benzodiazepine and antipsychotic once symptom remission achieved Maintenance Continue lithium monotherapy for 9 months (can lower to achieve serum level of 0.6-0.8 after symptom remission if severe side effects) For future pregnancies, begin prophylactic lithium monotherapy during pregnancy or immediately postpartum.

• #18 Management of New Onset Psychosis in the Postpartum Period

  https://www.psychiatrist.com/jcp/new-onset-psychosis-in-the-postpartum-period/

  In this article, we provide a synopsis of the clinical presentation and diagnosis of postpartum psychosis and review treatment and prevention strategies. […] Postpartum psychosis is managed as a psychiatric emergency as it is associated with an increased risk of suicide and potential risk to the infant. […] Inpatient psychiatric hospitalization is the recommended treatment setting due to risk of harm to mother and infant. Small treatment studies and case reports provide evidence for the use of lithium, antipsychotics, and electroconvulsive therapy (ECT). […] In this study, 98.4% of patients achieved remission within the first 3 steps of the algorithm. […] ECT is strongly considered in patients with catatonia and depression with psychotic features. […] While the patient is acutely psychotic, her contact with her infant may need to be limited due to risk for harm.

• #19 Postpartum Psychosis – PsychDB

  https://www.psychdb.com/psychosis/z-postpartum

  PPP is considered a psychiatric emergency, and requires immediate hospitalization and treatment. […] Various effective treatments include antipsychotics, benzodiazepines, mood stabilizers (in particular lithium), hormones, propranolol, and electroconvulsive therapy (ECT). […] Although pharmacological management is the main treatment, psychosocial supports including in particular sleep hygiene and general family and caregiver support is important. […] Treatment Recommendations for Acute Postpartum Psychosis: Step 1 Benzodiazepine (lorazepam 0.5-1.5 mg TID) Step 2 Antipsychotic (high potency preferred, haloperidol 2-6 mg or olanzapine 10-15 mg) Step 3 Lithium (to achieve serum level of 0.8-1.2 mmol/L) Step 4 Taper benzodiazepine and antipsychotic once symptom remission achieved Maintenance Continue lithium monotherapy for 9 months (can lower to achieve serum level of 0.6-0.8 after symptom remission if severe side effects) For future pregnancies, begin prophylactic lithium monotherapy during pregnancy or immediately postpartum.

• #20 Postpartum Psychosis: Symptoms, Treatment and More

  https://www.healthline.com/health/parenting/postpartum-psychosis

  Postpartum psychosis is a medical emergency. A person should call 911 and seek treatment at an emergency room, or have someone take them to an emergency room or crisis center. Often, a woman will receive treatment at an inpatient center for at least a few days until her mood is stabilized and she is no longer at risk for harming herself or her baby. […] Treatments during the psychotic episode include medications to reduce depression, stabilize moods, and reduce psychosis. Examples include: […] Antipsychotics: These medications reduce the incidence of hallucinations. Examples include risperidone (Risperdal), olanzapine (Zyprexa), ziprasidone (Geodon), and aripiprazole (Abilify). […] Mood stabilizers: These medications reduce manic episodes. Examples include lithium (Lithobid), carbamazepine (Tegretol), lamotrigine (Lamictal), and divalproex sodium (Depakote).

• #21 Postpartum Psychosis: Symptoms, Causes, Treatment

  https://www.mentalhealth.com/library/postpartum-psychosis-symptoms-causes-treatment

  Postpartum psychosis is a rare and severe mental health disorder that can occur after pregnancy. Symptoms vary from person to person and can be treated using medication and talking therapy. […] If someone is diagnosed with postpartum psychosis, they are usually taken to a mother and baby unit (MBU) so that the person with the diagnosis can be treated with their baby. In most cases, postpartum psychosis is treated with a combination of talking therapy and medication. It is most often treated in a hospital or other medical facility, i.e., MBU or psychiatric ward for the first few days. […] Common medications used to treat postpartum psychosis are listed below and are used on their own or in combination with each other: Antipsychotics help to treat psychotic and manic symptoms, including hallucinations and delusions. Examples include risperidone, aripiprazole, olanzapine, and ziprasidone. Mood stabilizers include medications such as lithium to calm extreme manic and depressed moods. Other examples include lamotrigine, divalproex sodium, and carbamazepine. Antidepressants, such as SSRIs, can be used alongside mood stabilizers to treat symptoms of depression and help to support an improved night’s sleep.

• #22 Treatment of postpartum psychosis in breastfeeding females in: Mental Health Clinician Volume 14: Issue 5 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/14/5/article-p277.xml?searchresult=1

  The first priority of treatment should be ensuring the mother and child are safe; although not ideal, hospitalization of the mother suffering from PPP is pertinent. Additionally, it is important to avoid leaving the mother alone with the child as the infanticide rate of PPP ranges from 1% to 4.5%. For the treatment of PPP, the impacts of benzodiazepines, antipsychotics, lithium, and electroconvulsive therapy (ECT) have been studied. […] There is no specific clinical treatment guideline for PPP; however, the American College of Obstetricians and Gynecologists (ACOG) provides a few recommendations in their (2023) guideline. Specifically, it is recommended that a psychiatrist provide assessment and treatment for the patient with PPP. Additionally, the ACOG discourages the use of antidepressants for acute depression with psychosis, especially without the presence of appropriate mood stabilization. Further, initiation of a sedative antipsychotic medication, such as olanzapine or haloperidol, with short-acting benzodiazepines, such as lorazepam, is the first-line recommended treatment for PPP during the acute stabilization period while awaiting assessment by a psychiatrist.

• #23 Postpartum psychosis: Protecting mother and infant | MDedge

  https://blogs.the-hospitalist.org/content/postpartum-psychosis-protecting-mother-and-infant

  The SGAs olanzapine and quetiapine are often used to manage acute symptoms because they are considered acceptable during breastfeeding. […] Postpartum psychosis (PPP) typically presents with a rapid onset of hallucinations, delusions, confusion, and mood swings within days to weeks of giving birth. Mothers with PPP almost always require hospitalization for the safety of their infants and themselves. Mood stabilizers and second-generation antipsychotics are used for acute management.

• #24 Postpartum Psychosis: A Primer | CARLAT PUBLISHING

  https://www.thecarlatreport.com/articles/4506-postpartum-psychosis-a-primer

  Postpartum psychosis requires immediate admission to an inpatient facility. Treat postpartum psychosis as you would treat an episode of psychotic mania, ie, with an antipsychotic, a mood stabilizer, and a benzodiazepine for agitation. Compared to other mood stabilizers, lithium appears most effective for postpartum psychosis (Bergink V et al, Am Journ of Psych 2016;173(12):11791188). With treatment, most patients (98%) recover within seven weeks (Bergink V et al, Am Journ of Psych 2015;172(2):115123). […] Provide psychoeducation to family members about the importance of sleep, medication adherence, and follow-up appointments with psychiatry and OB/GYN, and inform them that the mother should not be left alone with the child until psychotic symptoms have fully resolved. Once the patient is in remission, you can taper the antipsychotic and the benzodiazepine, but continue lithium as monotherapy for at least nine months. If you see any reason for concern about underlying BD, continue lithium with close monitoring. […] If your patient does not respond well to pharmacotherapy after two to four weeks, consider ECT, particularly for patients with psychosis complicated by catatonia, severe agitation, or refusal to eat or drink.

• #25 Treatment of postpartum psychosis in breastfeeding females in: Mental Health Clinician Volume 14: Issue 5 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/14/5/article-p277.xml?searchresult=1

  Lithium is another therapeutic option for PPP. The ACOG does not provide specific dosing recommendations for lithium treatment; one source recommends a target level of 0.8-1.2 mmol/L for acute stabilization and a target level 0.6-0.8 mmol/L for relapse prevention. Currently brexanolone and zuranolone are recommended treatments for postpartum depression; however, there are no studies that examine the efficacy of these medications for treatment of PPP. From a nonpharmacological standpoint, ECT has also shown benefits in refractory cases and for patients with catatonia or severe depression symptoms. Additionally, foregoing breastfeeding overnight as part of sleep preservation can also be helpful in the early phase of treatment and stabilization. If treated appropriately and quickly, the ACOG guidelines suggest full remission of PPP can be achieved when the mother is approximately 2 months postpartum.

• #26 Postpartum Psychosis: Symptoms, Treatment and More

  https://www.healthline.com/health/parenting/postpartum-psychosis

  Postpartum psychosis is a medical emergency. A person should call 911 and seek treatment at an emergency room, or have someone take them to an emergency room or crisis center. Often, a woman will receive treatment at an inpatient center for at least a few days until her mood is stabilized and she is no longer at risk for harming herself or her baby. […] Treatments during the psychotic episode include medications to reduce depression, stabilize moods, and reduce psychosis. Examples include: […] Antipsychotics: These medications reduce the incidence of hallucinations. Examples include risperidone (Risperdal), olanzapine (Zyprexa), ziprasidone (Geodon), and aripiprazole (Abilify). […] Mood stabilizers: These medications reduce manic episodes. Examples include lithium (Lithobid), carbamazepine (Tegretol), lamotrigine (Lamictal), and divalproex sodium (Depakote).

• #27 Postpartum Psychosis: Symptoms, Causes, Treatment

  https://www.mentalhealth.com/library/postpartum-psychosis-symptoms-causes-treatment

  Postpartum psychosis is a rare and severe mental health disorder that can occur after pregnancy. Symptoms vary from person to person and can be treated using medication and talking therapy. […] If someone is diagnosed with postpartum psychosis, they are usually taken to a mother and baby unit (MBU) so that the person with the diagnosis can be treated with their baby. In most cases, postpartum psychosis is treated with a combination of talking therapy and medication. It is most often treated in a hospital or other medical facility, i.e., MBU or psychiatric ward for the first few days. […] Common medications used to treat postpartum psychosis are listed below and are used on their own or in combination with each other: Antipsychotics help to treat psychotic and manic symptoms, including hallucinations and delusions. Examples include risperidone, aripiprazole, olanzapine, and ziprasidone. Mood stabilizers include medications such as lithium to calm extreme manic and depressed moods. Other examples include lamotrigine, divalproex sodium, and carbamazepine. Antidepressants, such as SSRIs, can be used alongside mood stabilizers to treat symptoms of depression and help to support an improved night’s sleep.

• #28 Treatment of postpartum psychosis – UpToDate

  https://www.uptodate.com/contents/treatment-of-postpartum-psychosis

  […] […] Individuals with mild level of disorganization […] […] […] For individuals with concurrent depressive symptoms […] […] […] For robust response […] […] […] For inadequate response […] […] […] Inadequate response to monotherapy […] […] […] Prominent insomnia […] […] […] For inadequate response to combination therapy

• #29 Treatment of postpartum psychosis in breastfeeding females in: Mental Health Clinician Volume 14: Issue 5 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/14/5/article-p277.xml?searchresult=1

  The first priority of treatment should be ensuring the mother and child are safe; although not ideal, hospitalization of the mother suffering from PPP is pertinent. Additionally, it is important to avoid leaving the mother alone with the child as the infanticide rate of PPP ranges from 1% to 4.5%. For the treatment of PPP, the impacts of benzodiazepines, antipsychotics, lithium, and electroconvulsive therapy (ECT) have been studied. […] There is no specific clinical treatment guideline for PPP; however, the American College of Obstetricians and Gynecologists (ACOG) provides a few recommendations in their (2023) guideline. Specifically, it is recommended that a psychiatrist provide assessment and treatment for the patient with PPP. Additionally, the ACOG discourages the use of antidepressants for acute depression with psychosis, especially without the presence of appropriate mood stabilization. Further, initiation of a sedative antipsychotic medication, such as olanzapine or haloperidol, with short-acting benzodiazepines, such as lorazepam, is the first-line recommended treatment for PPP during the acute stabilization period while awaiting assessment by a psychiatrist.

• #30 Postpartum psychosis – Wikipedia

  https://en.wikipedia.org/wiki/Postpartum_psychosis

  Postpartum psychosis Treatment, therapy […] Treatment may include medications such as benzodiazepines, lithium, and antipsychotics, as well as procedures such as electroconvulsive therapy (ECT). […] Treatment plans are made up of a combination of education, medication, and close follow-up care and support; the major goals of care include improving sleep and psychotic symptoms while helping to minimize major shifts in mood, such as depression and mania. […] Electroconvulsive therapy (ECT) is one of the available treatments for postpartum psychosis. […] ECT is considered an option for PPP when medications are ineffective. […] Lithium is the recommended medication for prevention of psychotic episodes in individuals who have a known history of bipolar disorder and/or previous episodes of PPP. […] Lithium can be administered as a medication by itself („monotherapy”) or as an additional medication with other psychiatric drugs („adjunctive therapy”). […] Benzodiazepines are currently only recommended as an add-on medication to lithium and/or antipsychotic drugs, usually in the setting of continued sleep disturbance despite the use of the other medications. […] Antipsychotic medications are the preferred class of drug used to treat general psychosis, including schizophrenia spectrum disorders. […] Current recommendations include antipsychotic use as an additional medication for patients receiving lithium, or antipsychotic use on its own for those who are unable to tolerate lithium.

• #31 Postpartum Psychosis – PsychDB

  https://www.psychdb.com/psychosis/z-postpartum

  PPP is considered a psychiatric emergency, and requires immediate hospitalization and treatment. […] Various effective treatments include antipsychotics, benzodiazepines, mood stabilizers (in particular lithium), hormones, propranolol, and electroconvulsive therapy (ECT). […] Although pharmacological management is the main treatment, psychosocial supports including in particular sleep hygiene and general family and caregiver support is important. […] Treatment Recommendations for Acute Postpartum Psychosis: Step 1 Benzodiazepine (lorazepam 0.5-1.5 mg TID) Step 2 Antipsychotic (high potency preferred, haloperidol 2-6 mg or olanzapine 10-15 mg) Step 3 Lithium (to achieve serum level of 0.8-1.2 mmol/L) Step 4 Taper benzodiazepine and antipsychotic once symptom remission achieved Maintenance Continue lithium monotherapy for 9 months (can lower to achieve serum level of 0.6-0.8 after symptom remission if severe side effects) For future pregnancies, begin prophylactic lithium monotherapy during pregnancy or immediately postpartum.

• #32 Treatment of postpartum psychosis in breastfeeding females in: Mental Health Clinician Volume 14: Issue 5 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/14/5/article-p277.xml?searchresult=1

  The first priority of treatment should be ensuring the mother and child are safe; although not ideal, hospitalization of the mother suffering from PPP is pertinent. Additionally, it is important to avoid leaving the mother alone with the child as the infanticide rate of PPP ranges from 1% to 4.5%. For the treatment of PPP, the impacts of benzodiazepines, antipsychotics, lithium, and electroconvulsive therapy (ECT) have been studied. […] There is no specific clinical treatment guideline for PPP; however, the American College of Obstetricians and Gynecologists (ACOG) provides a few recommendations in their (2023) guideline. Specifically, it is recommended that a psychiatrist provide assessment and treatment for the patient with PPP. Additionally, the ACOG discourages the use of antidepressants for acute depression with psychosis, especially without the presence of appropriate mood stabilization. Further, initiation of a sedative antipsychotic medication, such as olanzapine or haloperidol, with short-acting benzodiazepines, such as lorazepam, is the first-line recommended treatment for PPP during the acute stabilization period while awaiting assessment by a psychiatrist.

• #33 Postpartum psychosis – COPE

  https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/postpartum-psychosis/

  Medication is necessary for the treatment and management of postpartum psychosis to address the chemical imbalance that is leading to the range of extreme symptoms that the woman is likely to be experiencing. […] A specialist psychiatrist should be consulted when prescribing medications for postpartum psychosis. […] Mood stabilisers work to stabilise mood and help reduce the likelihood of the symptoms recurring (relapse). […] Antidepressants are used to treat the symptoms of depression that are part of the depression part of the disorder. […] Antipsychotics assist with both manic and psychotic symptoms such as delusions or hallucinations. […] Electroconvulsive Therapy (ECT) is a specialist treatment that may be included in the treatment of postpartum psychosis. […] There are safe and effective treatments for postpartum psychosis. Getting help as soon as possible can help reduce the impacts of this serious mental health condition on the mother, her partner, the infant and other members of the family.

• #34 Postpartum Psychosis: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24152-postpartum-psychosis

  Postpartum psychosis is treatable, and early treatment increases the odds of a good outcome. […] Because PPP is a mental health emergency, people with this condition need inpatient mental healthcare. This kind of care means trained medical professionals are with them at all times to make sure theyre safe and as comfortable as possible. […] The possible treatment methods include: Medications, Electroconvulsive therapy (ECT). […] Many different medication types can help PPP. The types include: Antipsychotic medications, Mood stabilizers, Antiseizure drugs, Lithium. […] Electroconvulsive therapy (ECT) is a safe and highly effective method for treating conditions that involve psychosis. This treatment uses a mild electrical current, passed through your brain, to induce a mild seizure. […] With treatment, this condition is reversible and many people who have it go on to have children in the future without a recurrence of PPP.

• #35

  https://journals.lww.com/ectjournal/fulltext/2012/03000/Electroconvulsive_Therapy__ECT__in_the_Treatment.10.aspx?generateEpub=Article%7Cectjournal:2012:03000:00010%7C10.1097/yct.0b013e3182315aa8%7C

  Postpartum psychosis is one of the most severe manifestations of postpartum mental illness. A psychiatric emergency, the prompt recognition and treatment of postpartum psychosis is essential in insuring maternal and infant well-being and safety. Here, we review the literature on the phenomenology of postpartum psychosis and the prevalence of use, safety, and efficacy of electroconvulsive therapy as a treatment. […] Based on our review, we argue that for some patients, electroconvulsive therapy should be the treatment of choice.

• #36 Postpartum psychosis – NHS

  https://www.nhs.uk/mental-health/conditions/post-partum-psychosis/

  Electroconvulsive therapy (ECT) is sometimes recommended if all other treatment options have failed, or when the situation is thought to be life threatening. […] As you move forward with your recovery, you may benefit from seeing a therapist for cognitive behavioural therapy (CBT). CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. […] With treatment and the right support, most people with postpartum psychosis do make a full recovery.

• #37 Postpartum depression – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/diagnosis-treatment/drc-20376623

  Postpartum psychosis requires immediate treatment, usually in the hospital. Treatment may include: […] Treatment may require a combination of medicines such as antidepressants, antipsychotic medicines, mood stabilizers and benzodiazepines to control your signs and symptoms. […] If your postpartum depression is severe and you experience postpartum psychosis, ECT may be recommended if symptoms do not respond to medicine. ECT is a procedure in which small electrical currents are passed through the brain, intentionally starting a brief seizure. ECT seems to cause changes in brain chemistry that can reduce the symptoms of psychosis and depression, especially when other treatments have been unsuccessful.

• #38 Postpartum Psychosis: What to Know About Symptoms and Treatment – The New York Times

  https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-pregnancy-what-symptoms-treatment.html

  Postpartum psychosis requires emergency care. With proper treatment, women can recover fully. One study of women with the diagnosis found that nearly all participants achieved remission. […] In the majority of cases, psychiatric hospitalization is required to protect the health of both the mother and the baby. […] Many experts consider mother-and-baby units (MBUs), which allow mothers and babies to remain together under careful supervision, the gold standard of care for postpartum psychosis. […] One study of mothers with severe postpartum psychosis who were admitted to an MBU — most of them involuntarily — found that all of them had improved by the time of discharge, and all left with custody of their child. […] One of the first goals of treatment in any type of facility is to help new mothers catch up on sleep, as doctors believe that sleep deprivation can trigger psychosis. Most women also receive medication, often a combination of benzodiazepines, antipsychotics and lithium. Research has shown that electroconvulsive therapy, or ECT, can effectively treat severe cases. […] Dr. Davis said there are three things she tells any woman experiencing postpartum psychosis: “You’re not alone, you’re not to blame, and with help you will get well.”

• #39 Treatment of postpartum psychosis in breastfeeding females in: Mental Health Clinician Volume 14: Issue 5 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/14/5/article-p277.xml?searchresult=1

  Lithium is another therapeutic option for PPP. The ACOG does not provide specific dosing recommendations for lithium treatment; one source recommends a target level of 0.8-1.2 mmol/L for acute stabilization and a target level 0.6-0.8 mmol/L for relapse prevention. Currently brexanolone and zuranolone are recommended treatments for postpartum depression; however, there are no studies that examine the efficacy of these medications for treatment of PPP. From a nonpharmacological standpoint, ECT has also shown benefits in refractory cases and for patients with catatonia or severe depression symptoms. Additionally, foregoing breastfeeding overnight as part of sleep preservation can also be helpful in the early phase of treatment and stabilization. If treated appropriately and quickly, the ACOG guidelines suggest full remission of PPP can be achieved when the mother is approximately 2 months postpartum.

• #40 Postpartum Psychosis: A Primer | CARLAT PUBLISHING

  https://www.thecarlatreport.com/articles/4506-postpartum-psychosis-a-primer

  Postpartum psychosis requires immediate admission to an inpatient facility. Treat postpartum psychosis as you would treat an episode of psychotic mania, ie, with an antipsychotic, a mood stabilizer, and a benzodiazepine for agitation. Compared to other mood stabilizers, lithium appears most effective for postpartum psychosis (Bergink V et al, Am Journ of Psych 2016;173(12):11791188). With treatment, most patients (98%) recover within seven weeks (Bergink V et al, Am Journ of Psych 2015;172(2):115123). […] Provide psychoeducation to family members about the importance of sleep, medication adherence, and follow-up appointments with psychiatry and OB/GYN, and inform them that the mother should not be left alone with the child until psychotic symptoms have fully resolved. Once the patient is in remission, you can taper the antipsychotic and the benzodiazepine, but continue lithium as monotherapy for at least nine months. If you see any reason for concern about underlying BD, continue lithium with close monitoring. […] If your patient does not respond well to pharmacotherapy after two to four weeks, consider ECT, particularly for patients with psychosis complicated by catatonia, severe agitation, or refusal to eat or drink.

• #41 Postpartum Psychosis: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24152-postpartum-psychosis

  Postpartum psychosis is treatable, and early treatment increases the odds of a good outcome. […] Because PPP is a mental health emergency, people with this condition need inpatient mental healthcare. This kind of care means trained medical professionals are with them at all times to make sure theyre safe and as comfortable as possible. […] The possible treatment methods include: Medications, Electroconvulsive therapy (ECT). […] Many different medication types can help PPP. The types include: Antipsychotic medications, Mood stabilizers, Antiseizure drugs, Lithium. […] Electroconvulsive therapy (ECT) is a safe and highly effective method for treating conditions that involve psychosis. This treatment uses a mild electrical current, passed through your brain, to induce a mild seizure. […] With treatment, this condition is reversible and many people who have it go on to have children in the future without a recurrence of PPP.

• #42 What Are Symptoms Of Postpartum Psychosis & Its Treatment | Blog | TalktoAngel

  https://www.talktoangel.com/blog/what-are-symptoms-of-postpartum-psychosis-and-its-treatment

  The following are some potential treatments: 1. Medications. 2. Electroshock treatment (ECT). […] PPP may benefit from a wide variety of drug types. The types consist of: Medicine that is antipsychotic. Stabilizers of mood. Anti-seizure medication. Lithium. […] A safe and extremely efficient way of treating diseases involving psychosis is electroconvulsive treatment (ECT). […] Because of its gruesome representations in literature, television, and film, ECT frequently has a bad reputation. However, ECT is performed when the patient is unconscious and under general anesthetic, so they won’t experience any pain or suffering. […] Many variables, including the therapies you receive and the symptoms you experience, can have an impact on the potential consequences and side effects. Because of this, the best person to inform you of the dangers, issues, or side effects you can or should anticipate is your healthcare professional.

• #43 ECT for Postpartum Psychosis – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/ect-for-postpartum-psychosis/

  Postpartum psychosis is a rare but serious psychiatric illness, occurring in about 1 to 2 per 1000 women after delivery. Because postpartum psychosis carries significant risks for both the mother and her child, most women with this illness are psychiatrically hospitalized. Electroconvulsive therapy (ECT) is an effective treatment for postpartum psychosis and may reduce the risks associated with medication exposure in the nursing infant; however, very few research studies have focused on the use of ECT in this setting and it is less commonly used in the United States than in other countries. […] This study indicates that ECT is well-tolerated and effective for the treatment of postpartum psychosis. While ECT is often reserved for the most severe cases of postpartum illness, this study suggests that it probably should be considered as a first-line treatment for women with postpartum psychosis.

• #44 Postpartum depression – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/diagnosis-treatment/drc-20376623

  Postpartum psychosis requires immediate treatment, usually in the hospital. Treatment may include: […] Treatment may require a combination of medicines such as antidepressants, antipsychotic medicines, mood stabilizers and benzodiazepines to control your signs and symptoms. […] If your postpartum depression is severe and you experience postpartum psychosis, ECT may be recommended if symptoms do not respond to medicine. ECT is a procedure in which small electrical currents are passed through the brain, intentionally starting a brief seizure. ECT seems to cause changes in brain chemistry that can reduce the symptoms of psychosis and depression, especially when other treatments have been unsuccessful.

• #45 Psychological interventions for managing postpartum psychosis: a qualitative analysis of women’s and family members’ experiences and preferences | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-019-2378-y

  Postpartum psychosis is a rare, yet severe disorder, in which early identification and immediate intervention are crucial. Despite recommendations for psychological input, little is known about the types of psychological intervention reported to be helpful. […] The results illustrate a range of areas in which psychological intervention could be delivered to facilitate and enhance recovery. Further research is needed to develop meaningful and effective psychological interventions and to investigate the most appropriate timing for this to be offered. […] Practical and social interventions reported to be helpful include support to enhance the mother-baby-interaction and access to information and support groups to help normalise their experiences and reduce feelings of isolation. Psychological intervention is also recommended.

• #46 Postpartum psychosis – NHS

  https://www.nhs.uk/mental-health/conditions/post-partum-psychosis/

  Electroconvulsive therapy (ECT) is sometimes recommended if all other treatment options have failed, or when the situation is thought to be life threatening. […] As you move forward with your recovery, you may benefit from seeing a therapist for cognitive behavioural therapy (CBT). CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. […] With treatment and the right support, most people with postpartum psychosis do make a full recovery.

• #47 Postpartum psychosis | Pregnancy Birth and Baby

  https://www.pregnancybirthbaby.org.au/postpartum-psychosis

  Electroconvulsive therapy is a process that stimulates nerve cells in the brain with an electric current to treat severe symptoms of mania, psychosis and severe depression. You might need this if your symptoms are severe. […] Psychological therapies, such as cognitive behaviour therapy (CBT) can help you to develop coping strategies as you recover. […] Recovery can be slow and take time. It’s important to minimise stress and try to sleep well. Consider limiting the number of visitors you have, especially as the beginning, as too many visitors can be overwhelming. […] Counselling and support for your partner and support people is also important.

• #48 Postpartum Psychosis: Updates and Clinical Issues

  https://www.psychiatrictimes.com/view/postpartum-psychosis-updates-and-clinical-issues

  Benzodiazepines may have a role in the acute treatment of postpartum psychosis. […] Electroconvulsive therapy (ECT) can yield rapid symptomatic improvement in mothers with postpartum psychosis or severe postpartum depression, but it may be challenging for women who have not previously received any psychiatric treatment to accept this treatment option. […] Establishing a regular sleep pattern is critical to the goal of improving the symptoms of postpartum psychosis. […] Engaging family members is important in the treatment plan for any woman suffering from postpartum psychosis. […] Lithium, divalproex, olanzapine, and estrogen have been examined for their efficacy in preventing the recurrence of psychosis.

• #49

  https://link.springer.com/article/10.1007/s00737-020-01025-z

  The importance of involving the family by providing information and fostering feelings of security and hope has also been reported by professionals working with women experiencing postpartum psychosis. […] Psychological support for families was needed to help develop family members understanding of postpartum psychosis, enhance their coping with the additional stress and enable them to know how to respond and cope with fear around relapse. […] The review reveals the complexity of recovery from postpartum psychosis and the need for intervention to be incorporated into a longer term recovery plan, which includes psychological and psychosocial needs alongside medical management.

• #50 Postpartum psychosis

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis

  During the worst part of your postpartum psychosis you will need practical help to care for your baby and also help to bond with your baby. Mother and Baby Unit (MBU) staff are trained to support you with every aspect of caring for your baby. If you do not go to an MBU, health visitors and mental health professionals can help and support you at home. […] You will usually need to have care from a community perinatal mental health service until you fully recover. This team can advise you about treatment and support for you and your family. You may also have a general adult mental health team. […] If your partner has postpartum psychosis, it can be very distressing for you even frightening or shocking. Do ask for help when your partner first has symptoms. This is particularly important if she does not understand that she is ill.

• #51 Postpartum Psychosis – A Comprehensive Review

  https://psychscenehub.com/psychinsights/postpartum-psychosis-review/

  The main pharmacological agents used are benzodiazepines, antipsychotics and lithium. […] Antipsychotics are recommended for the acute treatment of manic and psychotic symptoms. […] Lithium is highly efficacious for the acute and maintenance treatment of postpartum psychosis. […] The 4 step approach was used in a study for acute and maintenance treatment of patients hospitalised four weeks after delivery for the first onset of psychosis. […] Non-pharmacological approaches include blue-light-blocking glasses, sleep hygiene interventions, support for the other parent, and specific feedback designed to improve the mother-baby interaction. […] Women with postpartum psychosis usually have one of two disease courses: isolated postpartum psychosis or postpartum psychosis as an expression of bipolar mood disorder with non-perinatal episodes.

• #52 Postpartum psychosis – COPE

  https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/postpartum-psychosis/

  Recovery from the most severe symptoms of postpartum psychosis generally can take from between two weeks to twelve weeks (three months) depending on the individual, severity of your symptoms and your response to treatment. […] Developing a relapse prevention plan with a specialist is strongly advised. This can help you and your family identify and prepare, should the condition reoccur.

• #53 Postpartum Psychosis: Symptoms, Treatment and More

  https://www.healthline.com/health/parenting/postpartum-psychosis

  If a woman doesn’t respond well to medicines or needs further treatment, electroconvulsive shock therapy (ECT) is often very effective. This therapy involves delivering a controlled amount of electromagnetic stimulation to your brain. […] The most acute symptoms of postpartum psychosis can last anywhere from two to 12 weeks. Some women may need longer to recover, from six to 12 months. Even after the major psychosis symptoms go away, women may have feelings of depression and/or anxiety. […] Sometimes a doctor will prescribe a mood stabilizer like lithium for a woman to take after giving birth. This could potentially prevent postpartum psychosis.

• #54 Postpartum psychosis

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis

  It can take 6 -12 months or more to recover from postpartum psychosis. The most severe symptoms tend to last 2 to 12 weeks. You are likely to recover fully, but you may have another episode in the future. […] Many women who have had postpartum psychosis go on to have more children, but there is a high risk of having another episode. About 1 in 2 (50%) women who have had postpartum psychosis will have this again after the birth of another baby. With the right care, if you have another episode, you should be able to get help quickly.

• #55 Postpartum Psychosis: What to Know About Symptoms and Treatment – The New York Times

  https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-pregnancy-what-symptoms-treatment.html

  Postpartum psychosis requires emergency care. With proper treatment, women can recover fully. One study of women with the diagnosis found that nearly all participants achieved remission. […] In the majority of cases, psychiatric hospitalization is required to protect the health of both the mother and the baby. […] Many experts consider mother-and-baby units (MBUs), which allow mothers and babies to remain together under careful supervision, the gold standard of care for postpartum psychosis. […] One study of mothers with severe postpartum psychosis who were admitted to an MBU — most of them involuntarily — found that all of them had improved by the time of discharge, and all left with custody of their child. […] One of the first goals of treatment in any type of facility is to help new mothers catch up on sleep, as doctors believe that sleep deprivation can trigger psychosis. Most women also receive medication, often a combination of benzodiazepines, antipsychotics and lithium. Research has shown that electroconvulsive therapy, or ECT, can effectively treat severe cases. […] Dr. Davis said there are three things she tells any woman experiencing postpartum psychosis: “You’re not alone, you’re not to blame, and with help you will get well.”

• #56 Postpartum psychosis: research reveals full recovery possible within weeks | Parents and parenting | The Guardian

  https://www.theguardian.com/lifeandstyle/2017/apr/20/postpartum-psychosis-research-reveals-full-recovery-possible-within-weeks

  But new research being presented at the annual congress of the Royal Australian and New Zealand College of Psychiatrists on Thursday found that if properly recognised and treated, women experiencing postpartum psychosis could make a full recovery within weeks and successfully bond with and care for their babies at home. […] It found the women often required one-on-one nursing care, and all patients received antipsychotic medication. A few also required lithium, a mood stabiliser. […] This treatment saw almost all of the women make a complete recovery and able to return home to care for their babies after an average stay of four weeks, similar to the average stay for other mental health conditions. […] The president of the Royal Australian and New Zealand College of Psychiatrists, Professor Malcolm Hopwood, says the study shows the importance of identification and early intervention for women with postpartum psychosis. […] The good news for these women is that with the right care they can bond with their babies and care for them like any other new mother, he says. […] But the key is that once postpartum psychosis is identified, it is so, so treatable.

• #57 Postpartum psychosis

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis

  During the worst part of your postpartum psychosis you will need practical help to care for your baby and also help to bond with your baby. Mother and Baby Unit (MBU) staff are trained to support you with every aspect of caring for your baby. If you do not go to an MBU, health visitors and mental health professionals can help and support you at home. […] You will usually need to have care from a community perinatal mental health service until you fully recover. This team can advise you about treatment and support for you and your family. You may also have a general adult mental health team. […] If your partner has postpartum psychosis, it can be very distressing for you even frightening or shocking. Do ask for help when your partner first has symptoms. This is particularly important if she does not understand that she is ill.

• #58 Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00236-2

  Our primary recommendation for antipsychotic treatment was haloperidol at 26 mg/day. Patients who experienced side effects were switched to an atypical antipsychotic. […] After complete remission of symptoms, all women were advised to taper benzodiazepines to discontinuation. Women receiving antipsychotic monotherapy were advised to continue this treatment as maintenance therapy until nine months postpartum. Women who achieved clinical remission using both antipsychotics and lithium were advised to gradually taper off antipsychotic treatment, with maintenance lithium monotherapy until nine months postpartum. […] Understanding who is at risk of a mood or psychotic disorder during follow-up, and whose vulnerability is limited to the postpartum period, is particularly important in guiding treatment decisions including long-term pharmacotherapy. Unfortunately, no biomarkers are currently available to help guide these decisions. In clinical practice, this means that long-term monitoring is warranted for everyone with postpartum psychosis.

• #59 Understanding postpartum psychosis: From course to treatment – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/2021-reproductive-psychiatry/

  Some women appear to be able to discontinue treatment as noted above; others, particularly if there is any history of bipolar disorder, need to be maintained on treatment with mood stabilizer indefinitely. […] Our psychiatrists also can counsel clinicians on issues regarding long-term management of postpartum psychosis because for many, knowledge of precisely how to manage this disorder or the follow-up treatment may be incomplete. […] While some patients may be able to taper and discontinue treatment after, for example, a year of being totally well, to date we are unable to know who those patients are. […] Postpartum psychosis remains one of the most serious illnesses that we find in reproductive psychiatry, and incomplete attention has been given to this devastating illness, which we read about periodically in newspapers and magazines. […] Greater understanding of postpartum psychosis will lead to a more precision-like psychiatric approach, tailoring treatment to the invariable heterogeneity of this illness.

• #60 Postpartum psychosis

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis

  It can take 6 -12 months or more to recover from postpartum psychosis. The most severe symptoms tend to last 2 to 12 weeks. You are likely to recover fully, but you may have another episode in the future. […] Many women who have had postpartum psychosis go on to have more children, but there is a high risk of having another episode. About 1 in 2 (50%) women who have had postpartum psychosis will have this again after the birth of another baby. With the right care, if you have another episode, you should be able to get help quickly.

• #61 Postpartum psychosis: a practical management guide for obstetricians – O&G Magazine

  https://www.ogmagazine.org.au/20/3-20/postpartum-psychosis-a-practical-management-guide-for-obstetricians/

  Postpartum psychosis usually responds fairly quickly (within two to three weeks) to antipsychotic medication and sleep restoration. […] While the majority of women with a de novo episode dont relapse into psychosis later in life, 14 per cent will go on to develop a manic or depressive episode sometime in the next 15 or more years, consistent with an emerging bipolar disorder. […] Acute postpartum mental disturbance can range from mild symptoms, resolving with sleep restoration, through to more severe and florid presentations requiring antipsychotic treatment, and often hospitalisation. […] In patients with a prior history, a multidisciplinary team approach, a management plan, attention to avoidance of sleep deprivation in the third trimester, early intervention with hypnotic or antipsychotic medication, and a low threshold for transfer to a psychiatric facility or mother and baby unit, should be considered.

• #62 Postpartum psychosis – COPE

  https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/postpartum-psychosis/

  Recovery from the most severe symptoms of postpartum psychosis generally can take from between two weeks to twelve weeks (three months) depending on the individual, severity of your symptoms and your response to treatment. […] Developing a relapse prevention plan with a specialist is strongly advised. This can help you and your family identify and prepare, should the condition reoccur.

• #63 What is Postpartum Psychosis: Symptoms, Causes & Treatment – A Mission For Michael

  https://amfmtreatment.com/blog/what-is-postpartum-psychosis-symptoms-causes-treatment/

  In severe cases, inpatient care may be necessary to ensure the safety of the mother and the baby. Hospitalization provides a structured and supportive environment where the mother can receive intensive treatment and monitoring. […] Family and peer support are invaluable components of treatment for postpartum psychosis. Loved ones can offer emotional support, help with daily tasks, and provide a sense of stability during the recovery process. […] Long-term management of postpartum psychosis involves ongoing treatment and support. Regular follow-up appointments with healthcare providers are essential to monitor the mother’s progress and adjust treatment as needed. […] Preventing a recurrence of postpartum psychosis is an important aspect of long-term management. This involves addressing any underlying risk factors, such as by managing stress, ensuring adequate sleep, and maintaining a healthy lifestyle. […] At A Mission For Michael (AMFM), we offer comprehensive mental health services unique to the needs of individuals experiencing postpartum psychosis. Our team of experts provides personalized care, support, and guidance throughout the recovery process.

• #64 Understanding postpartum psychosis: From course to treatment – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/2021-reproductive-psychiatry/

  Dr. Lee S. Cohen, Director of the Ammon-Pinizzotto Center for Women’s Mental Health at Massachusetts General Hospital, recently shared his insights on diagnosing and treating postpartum psychosis with Ob.Gyn News on January 30th, 2020. […] From a clinical point of view, women with postpartum psychosis typically are hospitalized, given that this is both a psychiatric and potential obstetrical emergency. […] Clinical wisdom has dictated that, given the dramatic symptoms with which these patients present, most patients are treated with lithium and an antipsychotic medication as if they have a manic-like psychosis. […] Given that the risk for recurrent postpartum psychosis is so great (70%-90%), women with histories of postpartum psychosis invariably are prophylaxed with mood stabilizer prior to delivery in a subsequent pregnancy.

• #65 Postpartum Psychosis – A Comprehensive Review

  https://psychscenehub.com/psychinsights/postpartum-psychosis-review/

  Recognition of bipolar disorder postpartum is important to avoid misdiagnosis of bipolar disorder or mixed affective states as a unipolar disorder. […] Women with bipolar disorder: Consider continuation of medication as prophylaxis during pregnancy increases the likelihood of maintaining mood stability during pregnancy and preventing postpartum relapse. […] Women with isolated postpartum psychosis episode should begin prophylactic treatment immediately after birth, limited to the postpartum period.

• #66 Postpartum Psychosis – A Comprehensive Review

  https://psychscenehub.com/psychinsights/postpartum-psychosis-review/

  Recognition of bipolar disorder postpartum is important to avoid misdiagnosis of bipolar disorder or mixed affective states as a unipolar disorder. […] Women with bipolar disorder: Consider continuation of medication as prophylaxis during pregnancy increases the likelihood of maintaining mood stability during pregnancy and preventing postpartum relapse. […] Women with isolated postpartum psychosis episode should begin prophylactic treatment immediately after birth, limited to the postpartum period.

• #67 Postpartum psychosis – COPE

  https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/postpartum-psychosis/

  Recovery from the most severe symptoms of postpartum psychosis generally can take from between two weeks to twelve weeks (three months) depending on the individual, severity of your symptoms and your response to treatment. […] Developing a relapse prevention plan with a specialist is strongly advised. This can help you and your family identify and prepare, should the condition reoccur.

• #68 Psychological interventions for managing postpartum psychosis: a qualitative analysis of women’s and family members’ experiences and preferences | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-019-2378-y

  The emotional impact of postpartum psychosis and associated sense of loss remained with women for many years. […] Psychological interventions were sought at this time and are recommended to facilitate this adjustment process. Finally, as women seek to integrate their experiences, they may benefit from support to maintain their wellbeing, manage fear of relapse and plan for their future. Psychological approaches deemed useful are those incorporating acceptance or compassion based techniques, family interventions, trauma work and relapse prevention planning.

• #69 Postpartum Psychosis – A Comprehensive Review

  https://psychscenehub.com/psychinsights/postpartum-psychosis-review/

  The main pharmacological agents used are benzodiazepines, antipsychotics and lithium. […] Antipsychotics are recommended for the acute treatment of manic and psychotic symptoms. […] Lithium is highly efficacious for the acute and maintenance treatment of postpartum psychosis. […] The 4 step approach was used in a study for acute and maintenance treatment of patients hospitalised four weeks after delivery for the first onset of psychosis. […] Non-pharmacological approaches include blue-light-blocking glasses, sleep hygiene interventions, support for the other parent, and specific feedback designed to improve the mother-baby interaction. […] Women with postpartum psychosis usually have one of two disease courses: isolated postpartum psychosis or postpartum psychosis as an expression of bipolar mood disorder with non-perinatal episodes.

• #70 Postnatal psychosis | Mental Health Foundation

  https://mentalhealth.org.nz/conditions/condition/postnatal-psychosis

  Postnatal psychosis often requires treatment with antipsychotic drugs, mood stabilisers and/or antidepressants. These are usually prescribed by a specialist psychiatrist. The actual medication you are prescribed will depend on how severe your condition is and how you are feeding your baby. […] Your doctor will recommend a mix of treatment options that best suit you. This will usually include medication as well as talking therapy. […] With early recognition and treatment, and the right support, you will be able to reduce the risk and make a good recovery if you do experience postnatal psychosis. […] A health professional works with you, and your family/whānau, to provide information about the condition, its treatment, and how to support recovery. Central to this approach is that family/whānau, along with the person experiencing the condition, are critical members of the treatment team. […] It is also really important to look after your physical wellbeing. Make sure you get an annual check-up with your doctor, and do what you can to reduce stress, get enough sleep, eat a balanced diet and exercise. Being in good physical health will also help your mental health.

• #71 Treatment of postpartum psychosis in breastfeeding females in: Mental Health Clinician Volume 14: Issue 5 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/14/5/article-p277.xml?searchresult=1

  The ACOG guidelines recommend a sedative antipsychotic and short-acting benzodiazepine as the preferred treatment for PPP in acute stabilization. Some studies support the use of lithium for relapse prevention. Although antipsychotic monotherapy has not proven as effective as lithium for relapse prevention, it may be a preferred treatment option in breastfeeding patients, given safety concerns. Specific benzodiazepines and antipsychotics (ie, lorazepam and olanzapine, respectively) have evidence supporting safety in breastfeeding. While lithium is not contraindicated, there are still necessary monitoring parameters that need to be implemented for a breastfeeding mother and infant. ECT is considered a nonpharmacological treatment that can also be used, especially for cases that include catatonia or severe depression. Overall, to ensure patient-inclusive care, clinicians should conduct a risk versus benefit discussion regarding the treatment of PPP while breastfeeding.

• #72 Management of New Onset Psychosis in the Postpartum Period

  https://www.psychiatrist.com/jcp/new-onset-psychosis-in-the-postpartum-period/

  Postpartum psychosis is a psychiatric emergency. Immediate treatment with a combination of lithium, antipsychotics, and benzodiazepines has been demonstrated to be effective, and ECT may be required. […] Recommendations for long-term treatment and prevention of future episodes vary based on the patients psychiatric history, and a treatment plan should be made together with the patient based on her preferences, history of response, and the potential risks of treatment, as well as the patients desire to breastfeed.

• #73 Postpartum Psychosis: Updates and Clinical Issues

  https://www.psychiatrictimes.com/view/postpartum-psychosis-updates-and-clinical-issues

  Postpartum psychosis can be conceptualized as a psychiatric manifestation with abrupt onset following childbirth, an event filled with major biopsychosocial changes. […] Treatment is similar to that of nonpostpartum psychosis. Antipsychotics, mood stabilizers, and benzodiazepines are the interventions of choice. Treatment choice is also dictated by possible comorbidities, response to previous treatments, drug tolerability, the patients ability to cooperate, and whether the patient is breast-feeding. […] Lithium is an important medication for the management of postpartum psychosis. Monitoring of lithium levels, thyroid and renal function, and adequate hydration are standards of care when using lithium. […] Valproic acid or carbamazepine may be used to manage postpartum psychosis. […] Atypical antipsychotics are often first-line choices for psychosis and mania because of their tolerability.

• #74 Postpartum Psychosis: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24152-postpartum-psychosis

  Postpartum psychosis is treatable, and early treatment increases the odds of a good outcome. […] Because PPP is a mental health emergency, people with this condition need inpatient mental healthcare. This kind of care means trained medical professionals are with them at all times to make sure theyre safe and as comfortable as possible. […] The possible treatment methods include: Medications, Electroconvulsive therapy (ECT). […] Many different medication types can help PPP. The types include: Antipsychotic medications, Mood stabilizers, Antiseizure drugs, Lithium. […] Electroconvulsive therapy (ECT) is a safe and highly effective method for treating conditions that involve psychosis. This treatment uses a mild electrical current, passed through your brain, to induce a mild seizure. […] With treatment, this condition is reversible and many people who have it go on to have children in the future without a recurrence of PPP.

• #75 Postpartum Psychosis: What to Know About Symptoms and Treatment – The New York Times

  https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-pregnancy-what-symptoms-treatment.html

  Postpartum psychosis requires emergency care. With proper treatment, women can recover fully. One study of women with the diagnosis found that nearly all participants achieved remission. […] In the majority of cases, psychiatric hospitalization is required to protect the health of both the mother and the baby. […] Many experts consider mother-and-baby units (MBUs), which allow mothers and babies to remain together under careful supervision, the gold standard of care for postpartum psychosis. […] One study of mothers with severe postpartum psychosis who were admitted to an MBU — most of them involuntarily — found that all of them had improved by the time of discharge, and all left with custody of their child. […] One of the first goals of treatment in any type of facility is to help new mothers catch up on sleep, as doctors believe that sleep deprivation can trigger psychosis. Most women also receive medication, often a combination of benzodiazepines, antipsychotics and lithium. Research has shown that electroconvulsive therapy, or ECT, can effectively treat severe cases. […] Dr. Davis said there are three things she tells any woman experiencing postpartum psychosis: “You’re not alone, you’re not to blame, and with help you will get well.”

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