Can Specific Antidepressants Help Depressed Mothers Regain Parenting Skills?

Because maternal depression hurts children and raises their risk for depressive symptoms, successful treatment of the mothers might, correspondingly, benefit the children. These researchers analyzed data on 135 children whose 76 mothers had participated in a larger, 12-week, multisite, randomized, controlled treatment study in adults with unipolar major depression.

The treatment study had compared escitalopram (a selective serotonin reuptake inhibitor [SSRI]; 10–40 mg/day), bupropion (a norepinephrine-dopamine reuptake inhibitor and nicotinic acetylcholine receptor antagonist; 150–450 mg/day), and a combination of the two drugs. Mean doses were 24 mg/day of escitalopram, 245 mg/day of bupropion in monotherapy, and 314 mg/day of bupropion in combination therapy. Overall, 67% of mothers remitted, with no differences between treatment groups.

Contrary to expectations, maternal escitalopram monotherapy resulted in the greatest decreases in children's depression scores, in analyses adjusting for marital/cohabiting status, maternal age, and child's sex. In exploratory analyses, only this group showed improved parental functioning (specifically, “being able to talk to and listen to my child” and increased maternal care and affection) and clear links between decreased maternal and child depression scores. Escitalopram's impact was most pronounced among mothers with highest negative affectivity (guilt, hostility/irritability, and fear/anxiety).