South London and Maudsley NHS Foundation Trust, London, UK.
Trinity College Dublin, Dublin, Ireland.
J Psychopharmacol. 2023 Oct;37(10):960-970. doi: 10.1177/02698811231181573. Epub 2023 Jul 29.
Postpartum psychosis (PPP) is a psychiatric emergency that generally warrants acute inpatient care. PPP is marked by the sudden onset of affective and psychotic symptoms with a rapid deterioration in mental state. Evidence suggests that PPP is a discrete disorder on the bipolar disorder spectrum with a distinct treatment profile and prognosis.
We conducted a PubMed database search for various terms involving PPP and its treatment and included peer-reviewed articles published in English.
To provide a treatment algorithm for the management of PPP based on available evidence.
Pharmacological therapy is the mainstay of PPP management in the acute phase. Evidence points to a combination of antipsychotics and lithium in the acute treatment of PPP. Electroconvulsive therapy can offer a rapid treatment response where required. Lithium appears to have the best evidence for relapse prevention and prophylaxis in PPP. Psychoeducation is essential and psychosocial interventions used in bipolar disorder may be effective in PPP.
Early detection and prompt treatment with antipsychotics and lithium, followed by maintenance treatment with lithium, is associated with a favourable prognosis in PPP.
产后精神病（PPP）是一种精神科急症，通常需要急性住院治疗。PPP 的特点是情感和精神病症状突然发作，精神状态迅速恶化。有证据表明，PPP 是双相情感障碍谱系上的一种离散障碍，具有独特的治疗特征和预后。
我们在 PubMed 数据库中搜索了涉及 PPP 及其治疗的各种术语，并纳入了已发表的英文同行评议文章。
根据现有证据，为 PPP 的管理提供治疗算法。
药物治疗是 PPP 急性期管理的主要方法。有证据表明，抗精神病药物联合锂盐可用于 PPP 的急性治疗。在需要时，电惊厥治疗可以快速起效。锂盐在预防 PPP 复发方面似乎具有最佳的证据。心理教育是必不可少的，在双相情感障碍中使用的心理社会干预措施可能对 PPP 有效。
早期发现并及时使用抗精神病药物和锂盐进行治疗，随后用锂盐维持治疗，与 PPP 的良好预后相关。
