Pharmacological and Non-Pharmacological Interventions in the Management of Puerperal Psychosis

• DOI: https://doi.org/10.22533/at.ed.1594952423109

• Palavras-chave: Puerperal psychosis; Postpartum mental health; Antipsychotics; Mood stabilizers; Cognitive-behavioral therapy

• Keywords: Puerperal psychosis; Postpartum mental health; Antipsychotics; Mood stabilizers; Cognitive-behavioral therapy

• Abstract: INTRODUCTION Puerperal psychosis is a severe psychiatric disorder that emerges in the postpartum period, characterized by hallucinations, delusions, and severe mood disturbances. Although relatively rare, it poses significant risks to both the mother and infant, requiring prompt diagnosis and treatment. The introduction discusses the epidemiology, risk factors, and pathophysiology of puerperal psychosis, emphasizing the importance of early intervention and a multidisciplinary approach to treatment. OBJETIVE The main objective of this work was to analyze and evaluate the pharmacological and non-pharmacological treatment strategies for puerperal psychosis, focusing on antipsychotics, mood stabilizers, cognitive-behavioral therapy, and social support systems. It also aimed to explore the role of early intervention in improving treatment outcomes. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Puerperal psychosis” OR “Postpartum psychiatric disorders” OR “Pharmacological treatment” OR “Cognitive-behavioral therapy” OR “Maternal mental health”  in the last 5 years. RESULTS AND DISCUSSION The results section focused on pharmacological treatments, particularly antipsychotic medications and mood stabilizers, which are essential in managing acute symptoms. The discussion highlighted the challenges associated with using these drugs, particularly in breastfeeding mothers, and explored alternatives such as hormone-based therapies and electroconvulsive therapy for severe cases. Non-pharmacological treatments, such as cognitive-behavioral therapy and social support systems, were also examined, showing their effectiveness in reducing relapse rates and improving long-term outcomes. The role of early intervention, patient adherence, and ethical considerations were further emphasized, particularly regarding the balance between maternal mental health and breastfeeding. CONCLUSION The conclusion underscores the need for a holistic and individualized approach to managing puerperal psychosis, integrating both pharmacological and non-pharmacological treatments. Early diagnosis and intervention, combined with strong social support networks, are critical for ensuring favorable long-term outcomes. The work also points to future research in personalized medicine and pharmacogenomics as promising avenues for improving treatment efficacy and safety.