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PubMed1994

[Drug treatment of schizophrenic psychoses in puerperium].

Three schizophrenic patients and one schizophreniform patient, all experiencing puerperal psychosis, required a drug-induced delactation (bromocriptine) simultaneously to neuroleptic treatment. Taking into account the pharmacodynamic effects, an exacerbation of symptoms following bromocriptine (a D-2 receptor agonist) and an impairment of delactation following neuroleptic treatment (bringing about the blockade of D-2 receptors) are to be expected. In three cases, we carried out a combined bromocriptine-haloperidol treatment and, in one case, a bromocriptine-clozapine treatment. The above mentioned complications were not observed in any of the cases. The problems which may result from using clozapine during the puerperal period are also discussed.

Adult↗
PubMedDate not supplied

The nosology and prognosis of puerperal psychosis: a review.

Functional psychosis in the puerperal period is a dramatic phenomenon that presents a unique set of diagnostic and therapeutic challenges. Despite its omission from modern classificatory systems such as DSM-III and DSM-III-R, the concept of puerperal psychosis continues to receive support from clinicians on the basis of the apparently distinctive clinical picture that characterizes psychoses occurring at this time. The range of possible nosological models is considered in light of relevant studies of puerperal illness, and the evidence for and against each model is presented. The question of the prognosis of puerperal psychosis is reviewed and guidelines for its estimation in the individual case proposed. The heuristic importance of puerperal psychosis in terms of basic research and preventive psychiatry is also stressed.

Adult↗
PubMed1999

Role of estradiol in puerperal psychosis.

RATIONALE: Postpartum period has been considered a time of increased risk for the development of psychiatric disorders with long-lasting adverse consequences. Psychoses are the most severe of these illnesses and can be resistant to psychiatric medication. OBJECTIVE: We present two women with puerperal psychosis who had low serum estradiol, were refractory to neuroleptic medication but responded successfully to estradiol treatment. METHODS: Serum estradiol concentration was measured at baseline and during the treatment with sublingual 17-beta estradiol. Treatment effect was evaluated using Brief Psychiatric Rating Scale. RESULTS: Both patients had a low pretreatment estradiol concentration (28 and 54 pmol/l). During treatment with estradiol, the rise in serum estradiol coincided with a decline of psychotic symptoms. Discontinuation of estradiol treatment resulted in a rebound of florid psychotic symptoms in both cases. CONCLUSIONS: Estradiol may have a causal relation to postpartum psychosis and significance in the treatment of this illness.

Administration, Sublingual↗
PubMed1994

Follow-up and family study of postpartum psychoses. Part III: Characteristics of psychoses occurring exclusively in relation to childbirth.

As part of a follow-up and family study of postpartum psychoses, this episode of illness being the first leading to psychiatric hospitalisation, patients with puerperal episodes (PE) and nonpuerperal episodes (NPE) of illness in the long-term course (n = 79) were compared to patients with PE only (n = 40). Few differences were found. Relatives of patients with PE only had a lower morbidity risk for functional psychoses than relatives of patients with PE and NPE. A favourable course of illness in the presence of a low genetic predisposition may be expected, according to the diathesis-stress model of functional psychoses.

Adult↗
PubMed1976

[Clinical features and problems in the differential diagnosis of schizophrenic psychoses developing after delivery].

The authors report of some results of a clinical follow-up study of 76 schizophrenic patients in psychosis observed during the puerperal period. Two types of the process were distinguished: a recurrent type and attack-like progressive. Some diffrential diagnostical criteria are given permitting to differ recurrent schizophrenia from somatogenic and infectious psychoses.

Adult↗
PubMed1995

Increased psychological distress in post-partum, cocaine-using mothers.

This study investigated psychological symptoms, self-reported postpartum by poor, primarily African American women who used cocaine during pregnancy. Ninety-nine cocaine-using mothers (COC+) were compared to 44 noncocaine-using mothers (COC-) on standardized measures of psychological distress and verbal comprehension. Mothers were interviewed to determined extent of drug involvement. COC+ mothers reported using alcohol, marijuana, and tobacco at two to three times the rate of comparison mothers during pregnancy and reported earlier initiation of marijuana use. COC+ women were more likely to admit to interpersonal difficulties and to report phobic anxiety and paranoid ideational symptoms. The COC+ group was also more likely to have clinically elevated scores on subscales indicating feelings of personal inadequacy, phobic anxiety, and paranoia. The use of cocaine, in combination with either alcohol or marijuana, was the best predictor of psychoticism, hostility, and total number of distress symptoms.

Adult↗
PubMed1981

Psychiatric complications of progesterone and oral contraceptives.

Progesterone plays a critical role in the menstrual cycle, pregnancy, and sexuality. Its role in premenstrual syndrome, dysmenorrhea, and postpartum disorders is outlined. Oral contraceptives seem to affect mood and behavior in some women without preexisting psychiatric illness, sometimes inducing depression and loss of libido. When used as psychotropic agents, they can have mood-stabilizing effects and relieve premenstrual syndrome.

Adult↗
PubMed1987

Postpartum psychosis induced by bromocriptine.

Two multigravida patients with no prior psychiatric history were seen with postpartum psychosis, having received bromocriptine for inhibition of lactation. Bromocriptine given in high doses has been associated with psychosis in patients receiving the drug for Parkinson's disease. These cases demonstrate that bromocriptine may cause psychosis even when given in low doses.

Adult↗
PubMed2005

Menstrual psychosis.

This paper reviews the literature on menstrual psychosis and proposes a new classification, adapting that of v. Krafft-Ebing (1902) and Jolly (1914). The world literature consists mainly of case reports; they include a few with data good enough for a statistical demonstration of the link between onset and menses. These well-documented cases include examples of pre-menstrual, catamenial, paramenstrual and mid-cycle onsets, and continuous illnesses with phasic shifts rhythmic with the menstrual cycle. In sufferers, episodes seem to be concentrated around the menarche and after childbirth. The clinical picture resembles that of puerperal psychosis, and there are at least 20 women who have suffered both psychoses at different epochs in their lives. Both seem to fall within the manic depressive rubric, so that menstruation can be another trigger of a bipolar episode. Some work suggests an association with anovulatory cycles. Cases starting before the menarche suggest a diencephalic origin.

Journal Article↗