Postpartum psychosis – case report on effective treatment of electroconvulsive therapy in a patient with a history of neuroleptic malignant syndrome

Abstract

In this paper, we present a case of a 31-year-old patient with postpartum psychosis of an unusual course. In patients with antipsychotics, there have been significant complications of treatment in the form of a neuroleptic malignant syndrome. Because of the complications of pharmacological treatment, it was decided to withdraw antipsychotics and to use electroconvulsive therapy. Propofol was used for the anaesthesia of the patient; cisatracurium was used for muscle relaxation. In case of neuroleptic malignant syndrome, succinylcholine is contraindicated because of the increased risk of malignant hyperthermia. Due to the use of long-term anaesthetic agents, the patient required temporary intubation and respiratory support. A total of 8 ECT procedures were performed, complete disappearance of positive symptoms was achieved. After electroconvulsive treatment, aripiprazole 5 mg/d was administered, no significant complications were observed. The patient was discharged home with full mental status.