2019 issue 1

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Volume 35, issue 1

Case report

Postpartum psychosis – case report on effective treatment of electroconvulsive therapy in a patient with a history of neuroleptic malignant syndrome

Bogdan W. Stefanowski1, Anna Z. Antosik-Wójcińska1, Julia Jeschke1, Monika Dominiak1, Łukasz Święcicki1
1. Instytut Psychiatrii i Neurologii w Warszawie
Farmakoterapia w Psychiatrii i Neurologii 2019, 35 (1), 75–80
Date of publication: 16-05-2019
DOI: https://doi.org/10.33450/fpn.2019.04.003
Keywords: electroconvulsive therapy, neuroleptic malignant syndrome, postpartum psychosis

Abstract

In this paper, we present a case of a 31-year-old patient with postpartum psychosis of an unusual course. In patients with antipsychotics, there have been significant complications of treatment in the form of a neuroleptic malignant syndrome. Because of the complications of pharmacological treatment, it was decided to withdraw antipsychotics and to use electroconvulsive therapy. Propofol was used for the anaesthesia of the patient; cisatracurium was used for muscle relaxation. In case of neuroleptic malignant syndrome, succinylcholine is contraindicated because of the increased risk of malignant hyperthermia. Due to the use of long-term anaesthetic agents, the patient required temporary intubation and respiratory support. A total of 8 ECT procedures were performed, complete disappearance of positive symptoms was achieved. After electroconvulsive treatment, aripiprazole 5 mg/d was administered, no significant complications were observed. The patient was discharged home with full mental status.

Address for correspondence:
Anna Z. Antosik-Wójcińska
Instytut Psychiatrii i Neurologii
ul. Sobieskiego 9, 02-957 Warszawa, Poland
email: aantosik@ipin.edu.pl