Introduction. The postpartum period is considered a period of increased risk of developing bipolar affective disorder (BDII) type II. According to the available data, postpartum BDII is a highly neglected area of observation, with negative consequences for mothers, offspring, and the family as a whole. Case report. The paper describes the case of a patient with symptoms of a depressive episode of atypical features following childbirth. The patient had one mild postpartum depression episode and multiple previously detected hypomania-like episodes. Postpartum depression and bipolar affective disorder were detected in the family history. Escitalopram 20 mg in combination with Lamotrigine 200 mg was prescribed. There were no detected side effects to the prescribed therapeutic dose, and there have been no relapses so far. Conclusion. During pregnancy and postpartum, women should be screened for BDII. Based on the experience from the presented case, the combination of escitalopram and lamotrigine has shown promising results and complies with all recommended BDII treatment guidelines.
References
1.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 2013.
2.
Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RMA, Petukhova M, et al. Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2007;64(5):543.
3.
Stahl SM. Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications. 2016.
4.
Winter S. Gender trouble: The World Health Organization, the International Statistical Classification of Diseases and Related Health Problems (ICD)-11 and the trans kids. Sexual Health. 2017;14(5):423.
5.
Stojanov J, Stankovic M, Zikic O, Stankovic M, Stojanov A. The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic. The International Journal of Psychiatry in Medicine. 2021;56(4):228–39.
6.
Hirschfeld RMA, Williams JBW, Spitzer RL, Calabrese JR, Flynn L, Keck PE, et al. Development and Validation of a Screening Instrument for Bipolar Spectrum Disorder: The Mood Disorder Questionnaire. American Journal of Psychiatry. 2000;157(11):1873–5.
7.
Hidalgo-Mazzei D, Mateu A, Undurraga J, Rosa AR, Pacchiarotti I, Bonnin C del M, et al. e-HCL-32: a useful, valid and user friendly tool in the screening of bipolar II disorder. Comprehensive Psychiatry. 2015;56:283–8.
8.
Glover V, Liddle P, Taylor A, Adams D, Sandler M. Mild Hypomania (the Highs) can be a Feature of the First Postpartum Week. British Journal of Psychiatry. 1994;164(4):517–21.
9.
Balázs J, Benazzi F, Rihmer Z, Rihmer A, Akiskal KK, Akiskal HS. The close link between suicide attempts and mixed (bipolar) depression: Implications for suicide prevention. Journal of Affective Disorders. 2006;91(2–3):133–8.
10.
Propper L, Sandstrom A, Rempel S, Howes Vallis E, Abidi S, Bagnell A, et al. Attention-deficit/hyperactivity disorder and other neurodevelopmental disorders in offspring of parents with depression and bipolar disorder. Psychological Medicine. :1–8.
11.
Yatham LN, Kennedy SH, Schaffer A, Parikh SV, Beaulieu S, O’Donovan C, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009. Bipolar Disorders. 2009;11(3):225–55.
12.
Viguera AC, Whitfield T, Baldessarini RJ, Newport DJ, Stowe Z, Reminick A, et al. Risk of Recurrence in Women With Bipolar Disorder During Pregnancy: Prospective Study of Mood Stabilizer Discontinuation. American Journal of Psychiatry. 2007;164(12):1817–24.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
