Treatment-resistant, five-year long, postpartum-onset Capgras episode resolving after electroconvulsive therapy.
Postpartum psychosis, which rarely presents with Capgras syndrome (delusional misidentification), requires rapid symptom resolution. First-line drugs have important drawbacks, such as delayed onset of clinical response and secretion in breast milk. In this report, we report successful treatment of a treatment-resistant woman presenting with treatment-resistant Capgras syndrome, with onset during postpartum. A 36-year-old woman had presented with Capgras syndrome during postpartum. For more than five years, she believed her son and other family members were substituted by impostors. All adequately administrated treatments were unsuccessful. We suggested electroconvulsive therapy to overcome treatment resistance. After six electroconvulsive therapy sessions, delusions of doubles subsided and other symptoms improved. She was discharged two weeks later with a mood stabilizer and low-dose atypical antipychotic combination and is well at the one-and-a-half-year follow-up. Electroconvulsive therapy followed by a mood stabilizer-antipsychotic drug combination showed rapid, permanent, and effective control of long-standing Capgras syndrome in a young woman.
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy Department of Neuropsychiatry, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus, Viterbo, Italy rapinesi.chiara@libero.it.
Chiara
C
Rapinesi
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Georgios D
GD
Kotzalidis
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy Department of Psychiatric Rehabilitation, P. Alberto Mileno Onlus Foundation, Vasto, Italy.
Antonio
A
Del Casale
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy Department of Neuropsychiatry, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus, Viterbo, Italy.
Vittoria Rachele
VR
Ferri
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Simone
S
Di Pietro
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy Department of Neuropsychiatry, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus, Viterbo, Italy.
Paola
P
Scatena
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy Department of Neuropsychiatry, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus, Viterbo, Italy.
Daniele
D
Serata
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Emanuela
E
Danese
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Gabriele
G
Sani
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Alexia E
AE
Koukopoulos
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Gloria
G
Angeletti
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy Department of Neuropsychiatry, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus, Viterbo, Italy.
Paolo
P
Girardi
D000328:Adult; D002194:Capgras Syndrome / Q000628:therapy*; D004351:Drug Resistance; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D011644:Puerperal Disorders / Q000628:therapy*; D016896:Treatment Outcome
Capgras syndrome; Postpartum psychosis; electroconvulsive therapy; treatment resistance