Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-09T15:07:33.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Dopamine Supersensitivity and Hormonal Status in Puerperal Psychosis

Published online by Cambridge University Press:  02 January 2018

Christopher J. Meakin ,
Ian F. Brockington ,
Se Lynch  and
Stephen R. Jones
Christopher J. Meakin*
Affiliation:
Carlton Hayes Hospital, Narborough, Leicestershire
Ian F. Brockington
Affiliation:
Queen Elizabeth Psychiatric Hospital, Birmingham
Se Lynch
Affiliation:
Birmingham and Midland Hospital for Women, Sparkhill, Birmingham
Stephen R. Jones
Affiliation:
Queen Elizabeth Hospital, Birmingham
*
Dr C. J. Meakin, Carlton Hayes Hospital, Forest Road, Narborough, Leicestershire LE9 5ES
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

We examine the dopamine receptor supersensitivity hypothesis of puerperal psychosis, and explore puerperal changes in the functional sensitivity of this receptor system.

Method

Dopamine receptor sensitivity was estimated using growth hormone (GH) response to apomorphine challenge following delivery in 37 control women, and 11 deliveries in 10 women at ‘high risk’ of puerperal psychosis (previous history of puerperal affective or nonpuerperal manic psychosis). Tests were on days 4 or 5, 11 or 12 and at six weeks postpartum.

Results

Three women developing puerperal psychosis had subsensitive GH responsiveness on day 4. GH response to 67 challenge tests (in control and ‘high risk’ women) increased between days 4 or 5 and six weeks postpartum (P < 0.05). GH response at six weeks correlated with free thyroxine levels (P < 0.01).

Conclusions

These three cases do not support the stated hypothesis. Hypothalamic dopamine receptor sensitivity increases during the puerperium; thyroxine might influence this.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 1 , January 1995 , pp. 73 - 79
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Casper, R. C., Davis, J. M., Pandey, G. N., et al (1977) Neuroendocrine and amine studies in affective illness. Psychoneuroendocrinology, 2, 105–113.CrossRefGoogle ScholarPubMed
Cookson, J. C. (1982) Post-partum mania, dopamine and oestrogens. Lancet, ii, 672.CrossRefGoogle Scholar
DiPaolo, T., Poyet, P. & Labrie, F. (1981) Effect of chronic estradiol and haloperidol treatment on striatal dopamine receptors. European Journal of Pharmacology, 73, 105–106.CrossRefGoogle Scholar
Drago, F. & Scapagnini, U. (1986) Hormonal modulation of central dopaminergic transmission. Journal of Neural Transmission (suppl 22), 47–54.Google Scholar
Gordon, J. H. (1986) Modulation of apomorphine-induced stereotypy by oestrogen: time course and dose response. Brain Research Bulletin, 5, 679–682.CrossRefGoogle Scholar
Hirschowitz, J., Zemlan, F. P., Hitzemann, R. J., et al (1986) Growth hormone response to apomorphine and diagnosis: a comparison of three diagnostic systems. Biological Psychiatry, 21, 445–454.CrossRefGoogle ScholarPubMed
Jimerson, D. C., Cutler, N. R., Post, R. M., et al (1984) Neuroendocrine responses to apomorphine in depressed patients and healthy control subjects. Psychiatric Research, 13, 1–12.CrossRefGoogle ScholarPubMed
Kendell, R. E., Chalmers, J. C. & Platz, C. (1987) Epidemiology of puerperal psychosis. British Journal of Psychiatry, 150, 662–673.CrossRefGoogle Scholar
Kumar, R., Isaacs, S. & Meltzer, E. (1983) Recurrent postpartum psychosis. A model for prospective clinical investigation. British Journal of Psychiatry, 142, 618–620.CrossRefGoogle Scholar
Lal, S. (1988) Apomorphine in the evaluation of dopaminergic function in man. Progress in NeuroPsychopharmacology and Biological Psychiatry, 12, 117–164.CrossRefGoogle ScholarPubMed
Lal, S., Nair, N. P. V., Iskandar, H. I., et al (1982) Effect of domperidone on apomorphine-induced growth hormone secretion in normal men. Journal of Neural Transmission, 54, 75–84.CrossRefGoogle ScholarPubMed
Maany, I., Mendels, J., Frazer, A., et al (1979) A study of growth hormone release in depression. Neuropsychobiology, 5, 282–289.CrossRefGoogle ScholarPubMed
Noel, G. L., Suh, H. K. & Frantz, A. G. (1974) Prolactin release during nursing and breast stimulation in postpartum and non-postpartum subjects. Journal of Clinical Endocrinology and Metabolism, 38, 413–423.CrossRefGoogle Scholar
Paykel, E. S., del Campo, A. M., White, W., et al (1991) Neuroendocrine challenge studies in puerperal psychosis. Dexamethasone suppression and TRH stimulation. British Journal of Psychiatry, 159, 262–266.CrossRefGoogle ScholarPubMed
Riley, D. M. & Watt, D. C. (1985) Hypercalcemia in the etiology of puerperal psychosis. Biological Psychiatry, 20, 479–488.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robbins, E. (1978) Research Diagnostic Criteria. Rationale and reliability. Archives of General Psychiatry, 35, 773–782.CrossRefGoogle ScholarPubMed
Stewart, D. E., Addison, A. M., Robinson, G. E., et al (1988) Thyroid function in psychosis following childbirth. American Journal of Psychiatry, 145, 1579–1581.Google ScholarPubMed
Wehr, T. A., Sack, D. A. & Rosenthal, N. E. (1987) Sleep reduction as a final common pathway in the genesis of mania. American Journal of Psychiatry, 144, 201–204.Google ScholarPubMed
Wieck, A., Kumar, R., Hirst, A. D., et al (1991) Increased sensitivity of dopamine receptors and recurrence of affective psychosis after childbirth. British Medical Journal, 303, 613–616.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.