Depression and Alcoholism: Benefits of Simultaneous Treatments

Depressed people who are in treatment for alcoholism may benefit from being treated for both disorders at once, according to a new study from the University of Pennsylvania School of Medicine.

Alcoholism and depression often appear together. In one study of over 43,000 adults, about 21% of those who were dependent on alcohol were also clinically depressed. Among the alcoholics in treatment, the percentage with both conditions was over 40%. Traditionally, patients go through alcohol detoxification, psychotherapy and residential treatment for alcohol dependencies first, and after that, their doctors and therapists address the problems of depression. The reason for this is that alcoholism can cause depression, and it is easier to diagnose depression once alcoholism is no longer in the picture. Also, medications for depression react with alcohol.

This traditional way of treatment is called “sequential treatment” or treating the disorders in a sequence. “Parallel treatment” is rarer, and it occurs when both disorders are being treated at once, but in separate settings. “Integrated treatment” is when both problems are treated simultaneously in the same facility.

The new study from Pennsylvania looked at 170 alcohol-dependent patients with major depressive disorders. One group took Sertraline, an antidepressant; one group took naltrexone, a medication for alcoholism; one group took a combination of the two; and one group took placebos (sugar pills). After 14 weeks, the patients in the combination-drug group had the best results. They were able to remain abstinent almost three times longer than the other groups, and were less likely to be depressed.

“While it seems logical to prescribe anti-depressants for patients who are depressed, some alcohol-dependent patients, as well as some clinicians who treat them, are unwilling to treat them,” the authors wrote. “Fortunately, that bias is fading as scientists learn more about treating the addicted brain with certain medications and correcting the neurobiology of addiction.”

This study appears in the journal Psychiatric Times.