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Tijdschrift voor Psychiatrie 27 (1985) 8, 519 - 535

Short report

Therapeutic aspects of puerperal psychosis

M. Hebbrecht, R.A. Pierloot

This article intends to summarize the different psychopharmacological methods and the psychotherapeutic strategies — concerning the issue of puerperal psychosis. The advantages and the risks of the joint admission of psychotic mothers with their babies in a specialised unit of the psychiatric hospital are briefly discussed. More rigorous psycho-endocrine research is required to elucidate the significance of hormones in the pathogenesis of puerperal psychiatric disorders. Actually, the importance of hormonal preparations for the treatment of puerperal psychosis is doubtful. The co-administration of neuroleptics with antidepressants and/or lithiumcarbonate is mostly effective. The anti-cholinergic and anti-alpha-noradrenergic side-effects can provoke dangerous complications in the puerperal period. Breast-feeding for patients on psychotropic medications is contra-indicated. Bromocriptine possibly has some antipsychotic properties and is intended to stop breast-feeding artificially. The second step is electroconvulsive therapy which remains a safe and effective method. Psychotherapeutic measures are very important and tend to support the family system.