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Alcoholism & Addiction

New Drug Combo May Help Treat Depression & Alcohol Abuse

About 40% of the people who enter treatment for alcohol abuse are also severely depressed. Physicians and therapists in treatment centers usually address the most serious disorder first, followed by treatment for the other disorder. However, a new study suggests that it may be better to treat alcohol abuse and depression simultaneously by using drugs that address each condition.

Researchers from the Center for Studies Of Addiction in the Treatment Research Center at The University Of Pennsylvania School Of Medicine studied 170 alcohol-dependent patients with major depressive disorders for 14 weeks. Two different drugs were used: Naltrexone, a drug used to treat alcohol dependence, and an antidepressant medication called sertraline. Everyone in the study received weekly cognitive behavioral therapy, a form of individual counseling effective in substance abuse treatment. However, one group took only Naltrexone; another group took only sertraline; one group took a combination of the two drugs; and finally, one group took no drugs at all, just placebos. The group that took the combination had a higher rate of alcohol abstinence (54%) compared to 21% in the Naltrexone-only group, 23% in the sertraline-only group, and 23% in the placebo group.

The authors of the study said that doctors treating addictions are often reluctant to use drug therapies, because they "do not want to treat drugs with drugs."

"Fortunately, this attitude is fading as scientists impart knowledge to professionals and the public about the possibilities of correcting the neurobiology of addiction by treating the addicted brain with certain medications," author Helen Pettinati wrote in her report published in the journal Psychiatric Times. "While these findings require replication, they provide a practical recommendation to integrate or combine two medications — one for treating alcohol dependence and one for treating depression. The combined pharmacotherapy, with some platform counseling that integrates support and advice for both disorders, can provide an aggressive approach to treating co-occurring depression and alcohol dependence."

Statistics compiled on 43,093 adults in the National Epidemiologic Survey on Alcohol and Related Conditions found that 20% of those with major depressive disorders also had alcohol dependent disorders. Depression and alcohol dependence are risk factors for one another, and severity in one is associated with severity in the other. Alcohol dependence makes depression lasts longer. Patients who are depressed after they stop drinking are more likely to relapse into heavy drinking. Studies have also found that untreated depression predicts the worst outcome for alcoholic dependence.

The reason physicians usually do not treat the two disorders simultaneously is medications react with one another and with alcohol. Also, if the alcohol dependence is what causes the depression, then the depression will go away once the person stops drinking. In those cases, taking antidepressant drugs is not necessary.

Many physicians believe that genetic risk factors for mood disorders, including depression, may overlap for risk factors for alcohol dependence, which may be why the two disorders tend to "travel" together.

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