For the study, Myrna Weissman, Ph.D., of Columbia University and colleagues independently assessed 135 children (ages 7-17) and 76 depressed mothers participating in a 12-week double-blind randomized clinical trial testing the effects of escitalopram (10 mg to 40 mg daily), bupropion (150 mg to 450 mg daily), or a combination of the two.
While depressed mothers receiving escitalopram monotherapy, bupropion monotherapy, or combination treatment had a high remission rate overall (67%) and a significant reduction in symptoms over 12 weeks, only in the escitalopram group was significant improvement of the mothers' depression associated with improvement in the child’s symptoms.
The researchers suggest this difference may be due to changes in parental functioning. "Mothers in the escitalopram group reported significantly greater improvement, compared with the other groups, in their ability to listen and talk to their children, who as a group reported that their mothers were more caring over the 12 weeks," they wrote.
“This study highlights the complexity of interpreting the benefit of mothers’ medication treatment alone on children’s short-term outcomes,” Mary Jo Coiro, Ph.D., an assistant professor of psychology at Loyola University Maryland, wrote in an accompanying Perspectives piece in the journal. “Ultimately, a public health perspective that incorporates screening, prevention, and treatment of both parents and children is likely to be most effective in reducing the burden of parental depression. Interventions must offer a range of services and be flexible enough to identify which families require parenting support, medication, psychotherapy, home- or school-based services, and social services."
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