title: A cautionary note on the use of antidepressants in postpartum depression.
abstract: OBJECTIVE
  This paper discusses the effect of antidepressant use on the illness course in three women who were treated for first-onset postpartum depression (PPD) following childbirth.
  
  
  METHODS
  A report of three cases of early-onset PPD in which bipolarity manifested following antidepressant treatment.
  
  
  RESULTS
  There was no past history of psychiatric disturbance but in each case there was a family history of bipolar (BP) disorder. Treatment with antidepressants resulted in a highly unstable illness course characterized by a mixed episode, cycle acceleration, and a postpartum psychosis. However, discontinuation of antidepressants and institution of treatment with mood stabilizers and atypical neuroleptics resulted in sustained improvement and symptom remission.
  
  
  CONCLUSIONS
  Caution is urged in the use of antidepressants to treat early-onset PPD in women at risk for developing BP disorder due to a family history of bipolar illness.
authors.affiliation: Department of Psychiatry and Obstetrics & Gynecology, University of Western Ontario and Mood Disorders Program, Regional Mental Health Care London, ON, Canada. vsharma@uwo.ca
authors.forename: Verinder
authors.initials: V
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced*; D019052:Depression, Postpartum / Q000188:drug therapy; D005260:Female; D006801:Humans; D012306:Risk; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents