Preventing postpartum psychosis

Note: If a person with a history of postpartum psychosis becomes pregnant, seek psychiatric advice early to form a postpartum psychosis prevention plan.

Postpartum psychosis often reoccurs after subsequent births. If a person with a history of postpartum psychosis becomes pregnant, seek psychiatric advice early to form a postpartum psychosis prevention plan. The plan should include prevention strategies and postpartum mental state monitoring. Limited evidence supports offering lithium or an antipsychotic late in the third trimester or immediately after birth (within 1 day postpartum). The drug that was previously effective for postpartum psychosis is usually the drug of choice. Also consider whether the patient wishes to breastfeed; antipsychotics may be used while breastfeeding whereas lithium should not be used.

If the patient has not had an episode of postpartum psychosis by 3 months postpartum, seek psychiatric advice to slowly reduce then stop the drug.