post natal insomnia and anxiety

May 1, 2006

Hi folks,

Can anyone help with experience or ideas for treating a 37 year old lady who

had her first baby 2 weeks ago. About 3 days after the birth she started to feel

anxious and weepy and when I visited her struck me as someone in a state of

'shock'. She had a long and difficult labour with no sleep for three days and

lots of medication (AB's, oxytocin drip, pethedine) and now 21/2 weeks post

partum she has had almost no sleep since the birth. She is extremely anxious and

is having panic attacks. Her anxiety is worse at night and when she's alone. She

feels unwell and unable to cope. She is breastfeeding and this seems to be going

well.

The baby is the result of fertility treatment (she had very high prolactin

levels and they had donor insemination due to previous cancer making husband

infertile) and was desperately wanted for many years.

At day 3 I gave her some Passiflora drops 20- 30 gtt prn max qid as she was

having trouble sleeping. A couple of days later we added some Citrus flos 20 gtt

as above and this seemed tio work quite well and when I visited her the next day

she seemed calmer. We then had a full consultation and I prescribed a mix of

Avena 30, Scutellaria 15, Verbena 20, Withania 70 and Carduus 15 - 7.5ml cum aq

cal tds. Things then deteriorated and I think she only had one dose of the main

mix as she became so anxious she was too worried to take it in case it made her

feel ill. She then contacted the GP who prescribed a tranquilllizer so she could

get a night's sleep and arranged someopne to look after the baby during the

night, but again she was too anxious to take the medication. Her husbadnd is

very supportive but starting to feel angry and confused. She's also taking fish

oils and a multivit

Any thoughts?

Vitex?

Anyone have experience of treating PND with this severe anxiety?

Thanks

Mandy

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