Clinical Case DiscussionAdd-on Oxytocin in the Treatment of Postpartum Acute Schizophrenia: A Case ReportMedved, Sara MD; Bajs JanoviĆ, Maja MD; Štimac, Zoran MD; MihaljeviĆ-Peleš, Alma MDAuthor Information MEDVED, BAJS JANOVIĆ, and ŠTIMAC: Department of Psychiatry and Psychological Medicine, Zagreb University Hospital Centre, Zagreb, Croatia MIHALJEVIĆ-PELEŠ: Department of Psychiatry and Psychological Medicine, Zagreb University Hospital Centre, and School of Medicine, University of Zagreb, Zagreb, Croatia The authors declare no conflicts of interest. Please send correspondence to: Sara Medved, MD, Department of Psychiatry and Psychological Medicine, Zagreb University Hospital Centre, Kišpatićeva 12, Zagreb 10 000, Croatia (e-mail: [email protected]). Journal of Psychiatric Practice: July 2021 - Volume 27 - Issue 4 - p 326-332 doi: 10.1097/PRA.0000000000000557 Buy Metrics Abstract An increasing body of research has been published concerning the potential impact of oxytocin (OT) in the pathophysiology of neuropsychiatric disorders that affect social functioning, such as schizophrenia. The possible therapeutic effect of OT in promoting mother-child bonding could be valuable in the management of postpartum psychosis. Studies on the efficacy of OT as an add-on therapy in the treatment of schizophrenia have found reductions in both positive and negative symptoms. The patient in the case reported here developed her second psychotic episode at the age of 22, a month after delivering her first child. Four weeks after treatment with aripiprazole was initiated, the patient’s negative symptoms persisted, causing problems in the mother-child interaction. Intranasal OT (40 IU/d) was then added to the aripiprazole. Assessment scales [the Positive and Negative Syndrome Scale (PANSS), the Disability Assessment Schedule (WHODAS 2.0), and the Barkin Index of Maternal Functioning (BIMF)] and qualitative data from her caregiver were obtained at baseline and in the third and eighth weeks after the end of the OT therapy. Improvement was observed on almost all of the domains of the WHODAS 2.0 and the BIMF, as well as on the PANSS negative and general psychopathology scales. Data from the patient’s caregiver indicated an overall improvement in mother-child interaction. These results, especially the improvement in results on the PANSS scale, are similar to findings from previous studies in patients with schizophrenia. OT seems to boost the antipsychotic effect on positive symptoms through the OT dopamine pathway, while the effect on negative symptoms probably involves a more general mechanism. Because the postpartum period is of immense significance for child development and mental well-being, future research to investigate the therapeutic efficacy of OT in the management of postpartum psychosis is warranted. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.