A cautionary note on the use of antidepressants in postpartum depression


  • Verinder Sharma

    1. Department of Psychiatry and Obstetrics & Gynecology, University of Western Ontario and Mood Disorders Program, Regional Mental Health Care London, ON, Canada
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  • The author of this paper does not have any commercial associations that might pose a conflict of interest in connection with this manuscript.

Verinder Sharma, Mood Disorders Program, Regional Mental Health Care London, 850 Highbury Avenue North, PO Box 5532, Station B, London, ON, Canada N6A 4H1. Fax: 519 455 3011; e-mail: vsharma@uwo.ca


Objectives:  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.