Postpartum Psychosis: A Review of Pharmacological Therapy Options

Abstract

Postpartum psychosis is a severe postpartum mental health emergency characterized by mood swings, abnormal thinking or behavior, and confusion. Factors such as hormonal and psychological changes in the mother during pregnancy and the postpartum period, stress and a psychiatric disorder play an essential role in the development of postpartum psychosis, together with a genetic predisposition. Although this condition is most common in patients who have been or will be diagnosed with bipolar disorder, it may also occur less frequently in women with psychosis, schizophrenia, or major depression with schizoaffective disorder. In some patients, this situation may remain isolated in the postpartum period and not progress to any mood-destroying or psychotic disorders in the future. In a group of patients, this psychosis may manifest itself in the future. This psychiatric emergency can cause serious harm to both the mother and the baby, so postpartum psychosis should be recognized and treated as quickly as possible. There is no single guideline for the treatment of postpartum psychosis. Therefore, the treatment must be meticulously chosen by the clinicians according to the clinical characteristics of each patient. According to the data obtained from many clinics in recent years, it has been seen that the most effective treatments are antipsychotics, lithium, mood stabilizers, antidepressants, benzodiazepines, and electroconvulsive therapy (ECT). Therefore, facilitating and accelerating the clinician’s choice among these options will significantly contribute to managing postpartum psychosis. This review presents an analysis of current pharmacological treatment modalities in the treatment of postpartum psychosis.