Preventive treatment of pregnant women at high postpartum psychosis risk

March 9, 2012

(Medical Xpress) -- Twenty-nine pregnant women with a history of psychotic symptoms after previous deliveries, but not at other times, all remained stable without medication throughout their current pregnancies. Those who then began taking lithium or an antipsychotic within hours after delivery remained free of relapse after childbirth.

In contrast, relapse during pregnancy was common in women with bipolar disorder, especially in women who did not take medication during pregnancy. After delivery, most of the women with bipolar disorder took medication, but relapse nevertheless occurred in six of the ten who had experienced mood episodes during pregnancy.

This study of 70 women will be published online on March 8, 2012, at AJP in Advance, the ahead-of-print website of The (AJP), the official journal of the . The women were treated in the Peripartum of Veerle Bergink, M.D., and colleagues of Erasmus Medical Center in Rotterdam, the Netherlands. They were considered to be at high risk of postpartum psychosis because of either bipolar disorder or a history of postpartum psychosis only, without manic or at other times.

The pregnant women made their own decisions regarding whether to take medication during pregnancy and the . They were given information and recommendations regarding specific drugs and treatment options, and those who were taking a mood stabilizer at the time of evaluation were advised to continue during pregnancy.

Dr. Bergink stated, “Up to now, physicians haven’t known when to start medication to prevent postpartum psychosis. Many have thought that it has to start before delivery, but that exposes the fetus to possible adverse effects. Now women who have a history of psychosis limited to the postpartum period may be able to avoid that risk. On the other hand, in women with , medication during pregnancy appears critically important to maintain mood stability during pregnancy and to minimize the high risk of postpartum relapse.”

Robert Freedman, M.D., AJP Editor-in-Chief commented: “This unique study does not establish new guidelines for treatment, but it gives doctors and patients important data for their decisions on the benefits and risks for preventive treatment during pregnancy.”

The study was performed at the Erasmus Medical Center in Rotterdam, the Netherlands.

Explore further: Study: Breastfeeding does not protect against MS relapses

More information: ajp.psychiatryonline.org/AJPInAdvance.aspx

Related Stories

Study: Breastfeeding does not protect against MS relapses

July 6, 2011

New research finds breastfeeding doesn't appear to protect against multiple sclerosis (MS) relapses, despite previous studies suggesting there may be a protective role. The research is published in the July 6, 2011, online ...

Recommended for you

How we handle objects depends on who owns them

September 27, 2016

From scissors and staplers to car keys and cell phones, we pass objects to other people every day. We often try to pass the objects so that the handle or other useful feature is facing the appropriate direction for the person ...

Dogs ignore bad advice that humans follow

September 27, 2016

Dogs are less likely to follow bad advice than children, according to a new study conducted at the Canine Cognition Center at Yale. In contrast to children, dogs only copy a human's actions if they are absolutely necessary ...

The birth of politics in children—the case of dominance

September 26, 2016

As they grow up, do children become young Robin Hoods? Depending on their age, they do not allocate resources in the same way between dominant and subordinate individuals. Thus a tendency towards egalitarianism develops and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.