Alcoholism is a common disorder clearly responsible for considerable morbidity and mortality. Epidemiologic research has shown that depressive disorders are frequently co-morbid with alcoholism and appear to affect its course. Previously collected data from our group suggest that matching alcohol dependent patients who also have primary unipolar depression to treatment of both disorders is effective. The treatment consists of combining imipramine with relapse prevention counseling. The response rate in alcoholics with primary depression is limited by the side effects of imipramine and by its relatively poor efficacy in atypical depression. We propose to replicate and extend our work with a study of fluoxetine. We choose this medication because it is better tolerated, is effective for a wider spectrum of depression, and may reduce alcohol intake independent of antidepressant effects. Alcoholic patients with primary, current depression will have a 12 week trial of alcohol counseling using relapse prevention strategies combined with either fluoxetine or placebo. Forty subjects will complete each treatment, to test the efficacy of fluoxetine for both depression and drinking. Responders will be maintained in blind treatment for 12 additional weeks and followed openly for one year to more clearly assess the stability and the psychosocial dimensions of their recovery. The data generated will provide useful information regarding the treatment of this important subgroup of alcoholic patients.
| McGrath, P J; Nunes, E V; Quitkin, F M (2000) Current concepts in the treatment of depression in alcohol-dependent patients. Psychiatr Clin North Am 23:695-711, V |
| McGrath, P J; Nunes, E V; Stewart, J W et al. (1996) Imipramine treatment of alcoholics with primary depression: A placebo-controlled clinical trial. Arch Gen Psychiatry 53:232-40 |
