Perinatal Psychiatry

Question 1

What is puerperal psychosis?

Answer 1

An emergency and requires same day assessment by psychiatry if suspected
-usually presents within 2 weeks of delivery

Question 2

Early symptoms puerperal psychosis?

Answer 2

Sleep disturbance 
confusion 
Irrational ideas 
Progresses to 5% suicide risk
Hallucinations

Question 3

RF for development is puerperal psychosis?

Answer 3

Go into develop bipolar disorder
Previous episode of puerperal psychosis
1st degree relative with bipolar

Question 4

Treatment of peurperal psychosis?

Answer 4

Antipsychotics
Anti-Depressants
Mood stabilisers

Question 5

Postnatal depression?

Answer 5

2-6 weeks postnatal and lasts weeks to months

Question 6

Anti-depressants in pregnancy?

Answer 6

SSRI= first line: sertraline

Question 7

Antipsychotics in pregnant?

Answer 7

2nd generation drugs: olanzapine and quetiapine

Question 8

Pregnancy and bi-polar medication?

Answer 8

Switch to maybe queriapine

Increase monitoring is needed if lithium required

Question 9

Lithium in pregnancy?

Answer 9

Should be avoided

Assoc with cardiac abnormalities: Ebstein’s anomaly

Question 10

Anxiety meds in pregnancy?

Answer 10

SSRIs: first line
Benzos: In 3rd trimester can = floppy baby so generally avoid

Question 11

What antipsychotic to avoid in pregnancy?

Answer 11

Clozapine (agranulocytosis)

Question 12

Don’t breast feed with what drugs?

Answer 12

Lithium

Valproate