Trial reportThe American journal of psychiatry2012
Prevention of postpartum psychosis and mania in women at high risk.
Trial report in The American journal of psychiatry, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
49 citing papers in PubMed, 4 syntheses or guidelines pooled it, 237 citations in OpenAlex.
- Risk factors for relapse or recurrence in women with bipolar disorder and recurrent major depressive disorder in the perinatal period: a systematic review.Archives of women's mental health · 2023Pooled it
- Clinical Lactation Studies of Lithium: A Systematic Review.Frontiers in pharmacology · 2019Pooled it
- Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes.BMC pregnancy and childbirth · 2016Pooled it
- Preventive interventions for postnatal psychosis.The Cochrane database of systematic reviews · 2013Pooled it
- A prospective cohort study of antipsychotic medications in pregnancy: the first 147 pregnancies and 100 one year old babies.PloS one · 2014Trial
- Postpartum Psychosis and Bipolar Disorder: Review of Neurobiology and Expert Consensus Statement on Classification.Biological psychiatry · 2026Review
- Factors Associated With Severe Mental Illnesses Newly Diagnosed in Perinatal Psychiatric Care: Findings From a Large Clinical Cohort.Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists · 2026Article
- Postpartum depression prevalence, risk factors, and interventions among women in Punjab, Pakistan.Discover mental health · 2025Article
- Review
- The phenomenology of postpartum psychosis: preliminary findings from the Massachusetts General Hospital Postpartum Psychosis Project.Molecular psychiatry · 2025Article
- The lived experience of postpartum depression and psychosis in women: a bottom-up review co-written by experts by experience and academics.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2025Article
- Relationship between childhood trauma and postpartum psychotic experiences: the role of postnatal anxiety and depression as mediators.BMC psychiatry · 2024Article
- Postpartum Psychosis: A Preventable Psychiatric Emergency.Focus (American Psychiatric Publishing) · 2024Review
- Striking the Balance: Bipolar Disorder in the Perinatal Period.Focus (American Psychiatric Publishing) · 2024Review
- Sleep and Postpartum Psychosis: A Narrative Review of the Existing Literature.Journal of clinical medicine · 2023Review
- Postpartum psychosis: A proposed treatment algorithm.Journal of psychopharmacology (Oxford, England) · 2023Review
- The PPD-ACT app in Canada: feasibility and a latent class analysis of participants with postpartum depression recruited to a psychiatric genetics study using a mobile application.BMC psychiatry · 2022Article
- Postpartum Relapse in Patients with Bipolar Disorder.Journal of clinical medicine · 2022Review
- The course of bipolar disorder in pregnant versus non-pregnant women.International journal of bipolar disorders · 2021Article
- Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women.International journal of bipolar disorders · 2021Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWomen with a history of bipolar disorder or postpartum psychosis are at extremely high risk of relapse postpartum. Although lithium prophylaxis has demonstrated efficacy in reducing postpartum relapse, the timing of prophylaxis remains controversial given the balance of risks and benefits for the mother and fetus. The authors compared lithium use during pregnancy to its initiation postpartum in women at high risk for postpartum psychosis.
methodBetween 2003 and 2010, 70 pregnant women at high risk for postpartum psychosis were referred to the authors' psychiatric outpatient clinic. Women who were initially medication free were advised to start lithium prophylaxis immediately postpartum. Women already taking maintenance lithium during pregnancy were advised to continue treatment.
resultsAll women with a history of psychosis limited to the postpartum period (N=29) remained stable throughout pregnancy despite being medication free. Of the women with bipolar disorder (N=41), 24.4% relapsed during pregnancy, despite prophylaxis use by the majority throughout pregnancy. The postpartum relapse rate was highest in women with bipolar disorder who experienced mood episodes during pregnancy (60.0%). In contrast, none of the 20 women with a history of postpartum psychosis only who used postpartum prophylaxis relapsed, compared to 44.4% of patients with postpartum psychosis only who declined prophylaxis.
conclusionsThe authors recommend initiating prophylactic treatment immediately postpartum in women with a history of psychosis limited to the postpartum period, to avoid in utero fetal exposure to medication. Patients with bipolar disorder require continuous prophylaxis throughout pregnancy and the postpartum period to reduce peripartum relapse risk.
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