HRT

[Hayleynevin]

Hi, has anyone been prescribed HRT for postpartum psychosis? I have been advised to see a professor in London who recommends this instead of anti psychotics and any depressants medication? Interested in your thoughts. X

[HelenMW Volunteer]

Hello Hayley. I don't know if this helps but for my second and third pregnancies I did take progesterone therapy as soon as I delivered the babies. I went to London to talk about oestrogen therapy but choose progesterone as it meant I could breast feed. Hope this is helpful. Helen

[Hayleynevin in reply to HelenMW]

Hi Helen that helps loads thank you. Did you suffer with PP then I presume? Did the hormone replacement work for you and did you have anything else aswell such as anti depressants etc? Xx

[HelenMW Volunteer in reply to Hayleynevin]

Yes Hayley, my PP was in 1988 and it was severe and so out of the blue for our family. I thought I would never have another child but I did once I felt I had a plan. I also had places booked at the MBU just in case! If I can help further please don't hesitate to ask. I think this is what this site is good at. You can read my story somewhere on here if that helps too!! Love Helen x

[Hayleynevin in reply to HelenMW]

Thank you Helen so much. That's really helpful. I'm just really nervous about taking it and coming off my current meds incase it doesn't work! X

[caroline-p]

Like HelenMW I took progesterone immediately after delivery and by pessary for several weeks after my second and third babies, and I was fine. I breastfed both. It is a therapy which has not been subject to stringent trials, and seems to have fallen from favour with mainstream psychiatrists. There seems to be no downside to taking it. Just more research needed. It worked for me ( or I was just lucky) . That was 30 years ago.

[Hayleynevin in reply to caroline-p]

Hi Caroline. That's really good to know thank you. I'm on anti psychotic and anti depressants now and have been for last 3 years but it only keeps it at bay. When I come off I'm back in s bad place again. So willing to try anything else xx

[HelenMW Volunteer in reply to caroline-p]

Gosh Caroline I am so blessed to read your answer. My PP was in 1988 and I followed Katherina Daltons regime. Eating steady carbohydrates, taking progesterone injections for a week and then pessaries. I was fine for the 2nd and 3rd pregnancies. Good to read your response. Helen x

[caroline-p in reply to HelenMW]

Mine was the Katherina Dalton regime too. It involved injections of natural progesterone, then pessaries, rather than the tablets provided for HRT. My daughter managed to get the same treatment as a precautionary measure four years ago ( since there is a heritable increased risk). She was fine. The mental health experts would not prescribe it, but the obstetrician was happy to do so. If it can help stave off an attack it seems preferable to anti-psychotic drugs.

[Hayleynevin in reply to caroline-p]

This is sounding more positive the more you guys are replying. Dr.Studd in London replied saying 'yes PP can be and should be treated with Estrogens'. He sounds quite certain. What is this regime you speak of? Xx

[boat1 in reply to caroline-p]

Who prescribed the progesterone . Did u just buy it ?

[caroline-p in reply to boat1]

When I used it it was prescibed by my GP on the basis of the Katherina Dalton research. My daughter got it by asking her obstetrician to prescribe.

[Hannah_at_APP Administrator]

Hi Hayleynevin,

I don't have any personal experience to share on this, as my PP was treated with anti-psychotic medication, ECT and lithium as a mood stabiliser, which worked for me in my episode 8 years ago now. I'm sorry to hear that you've had a tough time trying to come off medication. I took meds for 3 years in total and each reduction was very carefully monitored by the MH team, which I hated at the time but can see that it was the right thing at the time for me.

I am seeking some further information from APP; as far as I'm aware, although there is no specific evidence base for HRT, some individuals do report benefit. I hope to have more information to share soon. Take care, xx

[Hayleynevin in reply to Hannah_at_APP]

Hi Hannah. It is a tough one isn't it! I'm wanting to give it a try but scared it will be the wrong move x

[Hidden]

Hello Hayleynevin,

I did not respond as I have had similar experiences to Hanna, but my partner investigated the route of HRT when I was extremely poorly. Until now I even did not know that it is possible! I am pleased that Hanna is investigating further for clarification.

I believe it is important to be able to get professional support in order to wean off from anti psychotics.

Thinking of you and hope you will receive the right guidance for a care plan, which is most suitable for your needs.

Take care

x

[Hayleynevin in reply to Hidden]

Hi, Thank you for your reply. You say your husband investigated the HRT route. Did you take this route? Xx

[Hidden]

Hello Hayleynevin,

my partner researched into anything at the time (PPP in 2010) in order to help me.

I was 39 days in a mixed psychiatric gender unit and suffered ongoing episodes. After many weeks of sleep deprivation, seclusion on numerous occasions and "ill treatment" by members of staff finally a combination of traditional antipsychotics tackled the psychotic outbursts.

Thanks to my partner and his "analytical mind and continuous observation of my symptoms and behaviour" he convinced external medical staff that the only way to get me better is the sanctuary of my home and to be with my baby and partner. I am not sure what would have happened, if the head of the department had been successful to section me from 2-3 & I do not need to go there...if and but is not constructive, one of the reasons why I live with the hear and now.

I can not change the past, but only can help others to talk about my experience. The after care and my support network was so much better whilst recovering. I am grateful to quite a few people, but I also have to pad myself on the shoulders; because I always have been willing to investigate all avenues and therapeutic opportunities. Like you, I asked for help!

Look after yourself and whichever path you chose, it has to suit your needs in order to get better.

x

[Hannah_at_APP Administrator]

Hello again, I just wanted to update you all with feedback from APP's experts as promised. APP’s experts say:

"Although hormonal changes may well play a role in PP we need more research to understand this better. At present, there is not enough evidence that treatment with oestrogen is beneficial in PP or for maintenance of mood stability after PP.

Katharina Dalton advocated the use of progesterone therapy for prevention of postpartum mood episodes a number of decades ago, and reported a number of positive case studies. However, there is still a lack of good evidence for it helping and there may in fact be a higher risk of depression in the group treated with progesterone. There haven’t been any studies examining progesterone and PP specifically.

The key clinical guidelines in the UK and around the world (e.g. NICE, SIGN) do not recommend oestrogen or progesterone in the treatment or prevention of PP. More research in this area would be very helpful."

I hope this provides some further info for you hayleynevin and also those reading and who have shared their experiences. PP whilst a horrible and cruel illness, is still hugely under-researched and treatment can vary by each person's experience. I also wondered if you had had a referral to Prof Ian Jones before hayleynevin? The link is here, and is free to access via GP or mental health team referral: app-network.org/what-is-pp/...

Take care, xx

[Hayleynevin in reply to Hannah_at_APP]

Hannah thank you so so much for looking in to this for me. That's so kind of you and has given me something to think about. I'll keep you all updated. Thank you again xxx

[boat1]

I have been wondering and researching about this. Glad you asked. I was without any episode during three pregnancies currently 29 wks and completely off medication. Even stopped lithium suddenly. History of bipolar 1 . The fact that there has been no recurrence suggests that the increase in hormones played a factor in keeping me well. Does anyone know if hormones are in prescription, can you just buy them and where, will they mix with medications like lithium , quetiapine. I am planning this post natally . It did work last time but I hate meds esp lithium. But I considering lithium even few wks before birth in order to lower the risk. I think research definitely needs to be done in this area. I am surprised it hasn't already . It's common knowledge that hormones drop significantly after birth. If anyone knows any more please share. I don't think my consultant wud approve any idea to convince her