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Post-partum psychosis is very rare. It is not so
much a variety of post-partum depression as it is an entity onto
itself. It is characterized by homicidal and suicidal impulses,
hallucinations, delusions, disorganized and bizarre thinking.
The dilemma is that these individuals usually refuse treatment.
This is a medical emergency situation. If post-partum psychosis
is suspected, families need to call 911 as emergency intervention
is necessary. Medication most likely will be prescribed. The ultimate
goal is to keep the baby and mother safe.
Research shows that approximately one woman in 1,000 births will
experience post-partum psychosis.
As with treating any psychosis, we need to first rule out any physiological
cause such as thyroid storms, seizure disorders or drug-induced
psychosis. Once ruled out, treatment is crucial. However before
individual or group therapy, medication must be given to alleviate
the psychotic symptomatolgy. In many cases, anti-psychotic medication
is administered only for a short period of time. Once the psychosis
abates, couple counseling, as well as individual counseling, can
be of benefit.
Family support, and educating the family regarding what has occurred
is also extremely important. It is important that the affected individual
not be labeled a bad mother. Once the psychosis is treated, mothers
generally go on to be good caretakers. It is important to note,
however, that in the event of future pregnancies, affected individuals
are at a 50% greater risk of having another psychotic episode.
Certain anti-psychotics have been more affective than others. Haldol,
Risperidal, Clozaril and Zyprexa have been beneficial in post-partum
psychosis.
Anti-psychotic medications do pass into the mother’s breast
milk. Subsequently if the mother has been breastfeeding and continues
to do so, the baby needs to be monitored for drowsiness or lethargic
behavior, and prescribing the least amount of anti-psychotic medication
in order for symptom reduction to occur is also crucial.
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