1 Department of Psychiatry, University of Western Ontario, London, ON, Canada.
J Hum Lact. 2018 Nov;34(4):745-748. doi: 10.1177/0890334418777695. Epub 2018 Jun 21.
The development of mania during weaning is an underreported phenomenon that has received little attention in the recent past. Lack of timely diagnosis and effective management can negatively affect not only the mother but also her family. Main issue: I describe the case of a woman who experienced onset of mixed mania during weaning. At that time, she was diagnosed with bipolar I disorder, current episode manic, and a mixed-features specifier. The woman had a history of bipolar II disorder and a family history of postpartum depression and bipolar disorder.
I prescribed quetiapine 200 mg at bedtime, and symptoms resolved within a couple of days. The woman is still taking the prescribed dose and has not had any recurrences since.
Weaning may act as a trigger for mixed mania, especially for women who have a history of bipolar disorder. Careful monitoring should occur during weaning for mothers with risk factors for bipolar disorder. Early recognition of symptoms and aggressive management is necessary to prevent hospitalization.
戒断期出现躁狂是一种报道较少的现象,在最近一段时间内并未受到太多关注。如果不能及时诊断和有效治疗,不仅会对母亲,还会对其家庭造成负面影响。主要问题:我描述了一位在戒断期出现混合躁狂的女性病例。当时她被诊断为双相 I 型障碍,当前发作为躁狂,伴有混合特征。该女性有双相 II 型障碍病史,且家族中有产后抑郁和双相障碍病史。
我给她开了喹硫平 200mg,睡前服用,几天后症状得到缓解。该女性仍在服用规定剂量的药物,此后未再复发。
戒断可能是混合躁狂的诱因,尤其是对有双相障碍病史的女性。有双相障碍风险因素的母亲在戒断期间应进行密切监测。早期识别症状并进行积极治疗对于预防住院非常必要。