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Suggest Treatment For Relapse Of Postpartum Psychosis
Question: Hi Doc,
My wife suffers from PP , she was diagnosed with PP on July 2014 ( we had our first baby in XXXXXXX 2014 ).
She was on invega injections , to which she responded well and then was put on medicine ARIPMT 15 mg and BEXOL 2mg , in that month ( december ) she was very fine but for last 5-7 days of December it was like if PP has come back , she had symptoms for these days we thought she might have skipped medicine that's why , but the same process repeated on XXXXXXX and Feb ( fine for 20 days and for 5-10 days symptoms of PP ) . Can you please help and advise if this is normal and what we need to do
My wife suffers from PP , she was diagnosed with PP on July 2014 ( we had our first baby in XXXXXXX 2014 ).
She was on invega injections , to which she responded well and then was put on medicine ARIPMT 15 mg and BEXOL 2mg , in that month ( december ) she was very fine but for last 5-7 days of December it was like if PP has come back , she had symptoms for these days we thought she might have skipped medicine that's why , but the same process repeated on XXXXXXX and Feb ( fine for 20 days and for 5-10 days symptoms of PP ) . Can you please help and advise if this is normal and what we need to do
Brief Answer:
Please get another consultation from treating doctor
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query and understand your concerns.
Although the prescribed treatment is appropriate for condition but it is possible that she i not regular on medication leading to relapse of her symptoms.
Secondly there is possibility that your wife need higher dose for treatment. Although 15 mg of Arip MT is good dose but some patient may require upto 30 mg a day.
Thirdly it is possible that current medication is not effective for her.
In my view you need to get another consultation for your wife as soon as possible. She may need addition of another medication or increase of dose of current medication.
I hope this answers your query.
If you have any other question feel free to write back to me.
Thanks and regards
Dr Ashok Kumar
Please get another consultation from treating doctor
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query and understand your concerns.
Although the prescribed treatment is appropriate for condition but it is possible that she i not regular on medication leading to relapse of her symptoms.
Secondly there is possibility that your wife need higher dose for treatment. Although 15 mg of Arip MT is good dose but some patient may require upto 30 mg a day.
Thirdly it is possible that current medication is not effective for her.
In my view you need to get another consultation for your wife as soon as possible. She may need addition of another medication or increase of dose of current medication.
I hope this answers your query.
If you have any other question feel free to write back to me.
Thanks and regards
Dr Ashok Kumar
Above answer was peer-reviewed by :
Dr. Raju A.T
Hello Doc,
Thanks for your suggestion.
I have few questions that bother my mind, please try to answer these
1. I spoke to our psychiatrist today he said, she should be put on injection again as medicine is not enough for her. So, any idea how long a person should be on injection shots ? and does a person recover fully with injection or they are to put
on medicine again?
2. She is taking Cabgolin medicine on Monday and Thursday for starting her mensuration cycle with the medicine mentioned above, isn't that cabgolin medicine reacting and becoming harmful for her condition as we see.
3. she was on injection and moved to oral medicine by our doctor and we are sure medicine was not skipped , is this normal for patient to have PP back after moving from injection to oral medicine ? and what should be kept in mind during making these changes
4. As you are familiar with the case now, can you please let know the duration till which the treatment goes on ( I understand it depends upon patient to patient ) , as per your experience and understanding of case any idea how long she should be on medicine.
5. And also, can we give her homeopathic treatment along with the treatment above
Thanks,
XXXX
Thanks for your suggestion.
I have few questions that bother my mind, please try to answer these
1. I spoke to our psychiatrist today he said, she should be put on injection again as medicine is not enough for her. So, any idea how long a person should be on injection shots ? and does a person recover fully with injection or they are to put
on medicine again?
2. She is taking Cabgolin medicine on Monday and Thursday for starting her mensuration cycle with the medicine mentioned above, isn't that cabgolin medicine reacting and becoming harmful for her condition as we see.
3. she was on injection and moved to oral medicine by our doctor and we are sure medicine was not skipped , is this normal for patient to have PP back after moving from injection to oral medicine ? and what should be kept in mind during making these changes
4. As you are familiar with the case now, can you please let know the duration till which the treatment goes on ( I understand it depends upon patient to patient ) , as per your experience and understanding of case any idea how long she should be on medicine.
5. And also, can we give her homeopathic treatment along with the treatment above
Thanks,
XXXX
Brief Answer:
injection is used for short term
Detailed Answer:
Dear XXXX,
Thanks for reverting back to me.
Generally injections are used when there is problem with medication intake or patient fails to respond with oral medications. They are used just for short term like one or two weeks and than patient shifted back to oral medications as soon as possible.
Cabergolon is used to reverse high level of prolactin and it has nothing to do with psychosis. In fact it is used to treat some side effects of antipsychotic medications. In my view cabgolin is not responsible for her symptoms.
This is not the usual but few patients fail to response with other mode of treatment while getting shifted. In the transition phase it is essential to get monitored repeatedly so early sign of relapse can be detected and appropriate measures can be taken. Other than that patient should not be subjected to any undue criticism and she should be allowed to do things as in past without any discrimination.
Most of the patients with post partum psychosis require treatment for at least 9 to 12 months after complete symptom remission. In few cases it may continue for longer duration.
Proper dosage with regular treatment is key for better outcome of patient.
I am not sure what homeopathic treatment you want to give. First get details of medication from homeo doctor so we can discuss.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
injection is used for short term
Detailed Answer:
Dear XXXX,
Thanks for reverting back to me.
Generally injections are used when there is problem with medication intake or patient fails to respond with oral medications. They are used just for short term like one or two weeks and than patient shifted back to oral medications as soon as possible.
Cabergolon is used to reverse high level of prolactin and it has nothing to do with psychosis. In fact it is used to treat some side effects of antipsychotic medications. In my view cabgolin is not responsible for her symptoms.
This is not the usual but few patients fail to response with other mode of treatment while getting shifted. In the transition phase it is essential to get monitored repeatedly so early sign of relapse can be detected and appropriate measures can be taken. Other than that patient should not be subjected to any undue criticism and she should be allowed to do things as in past without any discrimination.
Most of the patients with post partum psychosis require treatment for at least 9 to 12 months after complete symptom remission. In few cases it may continue for longer duration.
Proper dosage with regular treatment is key for better outcome of patient.
I am not sure what homeopathic treatment you want to give. First get details of medication from homeo doctor so we can discuss.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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