Treatment-resistant, five-year long, postpartum-onset Capgras episode resolving after electroconvulsive therapy

Chiara Rapinesi, Georgios D. Kotzalidis, Antonio Del Casale, Vittoria Rachele Ferri, Simone Di Pietro, Paola Scatena, Daniele Serata, Emanuela Danese, Gabriele Sani, Alexia E. Koukopoulos, Gloria Angeletti, Paolo Girardi

Research output: Contribution to journalArticlepeer-review


Postpartum psychosis, which rarely presents with Capgras syndrome (delusional misidentification), requires rapid symptom resolution. First-line drugs have important drawbacks, such as delayed onset of clinical response and secretion in breast milk. In this report, we report successful treatment of a treatment-resistant woman presenting with treatment-resistant Capgras syndrome, with onset during postpartum. A 36- year-old woman had presented with Capgras syndrome during postpartum. For more than five years, she believed her son and other family members were substituted by impostors. All adequately administrated treatments were unsuccessful.We suggested electroconvulsive therapy to overcome treatment resistance. After six electroconvulsive therapy sessions, delusions of doubles subsided and other symptoms improved. She was discharged two weeks later with a mood stabilizer and low-dose atypical antipychotic combination and is well at the one-and-a-half-year follow-up. Electroconvulsive therapy followed by a mood stabilizer-antipsychotic drug combination showed rapid, permanent, and effective control of long-standing Capgras syndrome in a young woman.

Original languageEnglish
Pages (from-to)227-234
Number of pages8
JournalInternational Journal of Psychiatry in Medicine
Issue number3
Publication statusPublished - Apr 1 2015


  • Capgras syndrome
  • Electroconvulsive therapy
  • Postpartum psychosis
  • Treatment resistance

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Medicine(all)


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