Harvard Mental Health Letter

In Brief: Treating depression along with alcohol dependence

Depression and alcohol dependence often go hand in hand. Being diagnosed with one of these disorders increases the risk of developing the other. Patients who are dependent on alcohol take longer to recover from depression, and those who remain depressed while trying to stay sober are more likely to start drinking again.

Unfortunately, there is little guidance for clinicians and patients about whether it's best to treat one disorder at a time or both at once. Fewer than a dozen controlled studies have evaluated the use of antidepressants in patients who are both alcohol dependent and depressed, for example, and these have produced conflicting results.

A double-blind, randomized, placebo-controlled study suggests that combining an antidepressant with naltrexone (ReVia) — a medication for alcohol dependence — may help depressed patients achieve sobriety. Investigators at the University of Pennsylvania randomly assigned 170 patients with major depression and alcohol dependence to one of four intervention arms: sertraline (Zoloft) alone, naltrexone alone, the combination, or double placebo. During the 14-week study, patients also participated in weekly cognitive behavioral therapy sessions and support groups.

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