Naslov
First onset postpartum psychosis and first line treatment: Series of five case studies remitted with olanzapine

Autori
Ćurković, Marko ; Bačeković, Ana ; Silić, Ante ; Ostojić, Draženka ; Jukić, Vlado

Izvornik
International journal of neuropsychopharmacology (1461-1457) 17 (2014); 161-161

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Postpartum psychosis, line treatment, case studies remitted, olanzapine

Sažetak
Objective: Postpartum psychosis [PPP] is rare disorder with an estimated prevalence in the general population of 1-2 per 1, 000 childbirths. PPP is a psychiatric emergency that requires inpatient psychiatric treatment because it can have negative consequences for the mother, infant, and entire family. Methods: We present five patients diagnosed with first onset PPP treated with olanzapine during the last year (2013th) in our Intensive care unit. All of our patients experienced clear phenomenological predominance of psychotic symptoms with no evidence of neither manic nor depressive symptoms. Results: Median age of our patients was 31 years(range 27-40 ; interquartile range [IQR] 10), all of them were primiparous, and experienced some of the obstetrical complications during delivery. None of our patient had previous history of psychiatric illnesses, and only one had positive family history. The median onset of psychotic symptoms that led to hospitalization occurred at 12 days postpartum (range 8-25 ; IQR 10, 5). Median duration of hospitalization was 11 days (range 6-38, IQR 20.5). One patient was discharged prior to achieving full remission because of the infectious complications, although she showed clear response to treatment prior to demission. We treated all patients with olanzapine, and we used bromocriptine for every patient to achieve ablactation. Supplementary therapy was used according to symptomatology and the progress of treatment, namely low doses of typical antipsychotics (n = 3), and benzodiazepines (n = 4). Two of our patients had a typical antipsychotic still included in discharge therapy, and three of them had benzodiazepines. Conclusion: According to out database search there are no clear guidelines regarding the treatment of first onset PPP in the patients with no prior history of psychiatric illnesses. According to our data, olanzapine proved itself as a valuable first line treatment. At this point there is a definite need for further investigations of preferably prospective design for the full understanding and possibly developing clear guidelines for PPP.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA