title: Protection against hormone-mediated mood symptoms.
abstract: We present the case of a woman with bipolar I disorder with severe premenstrual mood instability, confusion, and psychosis resembling the clinical features of postpartum psychosis when estrogen levels are expected to be low, and hypomania when estrogen levels are expected to be elevated. While depressive symptoms across the menstrual cycle have been extensively documented in the literature, there is little information regarding manic and hypomanic symptoms. In addition, we describe the successful treatment of her menstrual-cycle related symptoms. Approaches to the management of menstrual psychosis have not been systematically studied, and clinical guidelines do not exist. Clinical experiences such as the one reported here, in which the clinical formulation of the patient was consistent with known neuroendocrine phenomena and in which the treatment approach was successful, are crucial to developing promising approaches that can be tested in controlled trials.
authors.affiliation: Weill Cornell Medical College, NYP-Westchester Division, 21 Bloomingdale Road, OPD, White Plains, NY, 10605, USA. Lcs7001@med.cornell.edu.
authors.forename: Leah C
authors.initials: LC
authors.lastname: Susser
authors.affiliation: Weill Cornell Medical College, 315 East 62nd St 5th fl, New York, NY, 10065, USA.
authors.forename: Alison D
authors.initials: AD
authors.lastname: Hermann
mesh_terms: D000339:Affect; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D000069056:Lurasidone Hydrochloride / Q000627:therapeutic use; D008597:Menstrual Cycle / Q000523:psychology*; D011293:Premenstrual Syndrome / Q000188:drug therapy / Q000523:psychology*; D011618:Psychotic Disorders; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D014635:Valproic Acid; D008094:Lithium; D000069056:Lurasidone Hydrochloride
keywords: Bipolar disorder; Estrogen; Hormone-related mood symptoms; Menstrual psychosis; Psychosis