Our primary pharmacologic treatment recommendation
for high-risk women was lithium, based on the literature.
In contrast, studies using other prophylactic postpartum
treatment strategies in bipolar women either failed to
show efficacy, as in the case of estrogen administration
(35, 36) and valproate (23), or were inconclusive, as in the
case of olanzapine (37). Notably, the relapse rates in the
bipolar women receiving lithium prophylaxis in our study
were consistent with those in previous reports (9–12). To
our knowledge, no previous prophylaxis studies have independently
examined women with postpartum psychosis
limited to the postpartum period.
Clearly, more studies
are required to compare the efficacy of other potential
prophylactic treatment options (e.g., antipsychotics, carbamazepine)
with that of lithium, as well as their relative
efficacy for prophylaxis in bipolar women and those with
a history of psychosis limited to the postpartum period.