This is a 4-year project that proposes to evaluate with a double-blind, placebo controlled, 14-week clinical trial, whether pharmacologic treatment with sertraline, a potent and selective serotonin reuptake inhibitor, can significantly improve outcome for depressed alcohol dependent patients, when added to a standard hospital-based alcohol recovery treatment program. In addition, their outcome will be compared to that of nondepressed alcohol dependent patients. There will be 100 Ss (20% female), unrestricted by race and ethnic background, half of which will have a DSM-III-R diagnosis of Major Depression, as assessed by the SCID after two weeks of abstinence in inpatient treatment. The remaining 50 nondepressed alcohol dependent Ss will not meet DSM-III-R criteria for any depressive disorder or have a family history of depression, as assessed by the FH-RDC. Within each of the Depressed/Nondepressed groups, eligible Ss will be randomly assigned to either 200 mg/day of sertraline or 4 placebo tablets (maximum dosage will be titrated up in 50 mg increments, over a 2-week inpatient period). During the pharmacotherapy trial, clinical status and adverse effects will be regularly evaluated by a Physician Investigator. Compliance will be monitored with riboflavin marker, sertraline plasma levels and pill counts. A trained rater will also evaluate clinical status at baseline (inpatient) during the 12-week outpatient phase of the pharmacotherapy treatment trial (weekly for 6 weeks, and biweekly for 6 weeks), and at the follow-up visits. After discontinuing medication, Ss will be followed intensively for the first 6 weeks to monitor any development of depressive symptoms, adverse effects or increases in alcohol consumption. Three subsequent follow-up contacts will occur, at 3-month intervals through to 1 year, post-admission to inpatient treatment. Outcome will be determined using multiple measures that will include evaluating number of alcohol-free days, as well as changes in measures of problem severity in areas of medical, employment, psychiatric and social functioning. GGT, urine drug screen and a collateral report will also be obtained monthly for each S during their year-long participation.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Study Section
Special Emphasis Panel (SRCA (04))
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Carrier Foundation (Belle Mead, NJ)
Belle Mead
United States
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Pettinati, Helen M; Oslin, David W; Kampman, Kyle M et al. (2010) A double-blind, placebo-controlled trial combining sertraline and naltrexone for treating co-occurring depression and alcohol dependence. Am J Psychiatry 167:668-75
Ahmadi, Jamshid; Kampman, Kyle M; Oslin, David M et al. (2009) Predictors of treatment outcome in outpatient cocaine and alcohol dependence treatment. Am J Addict 18:81-6
Pettinati, Helen M; Rabinowitz, Amanda R (2006) Choosing the right medication for the treatment of alcoholism. Curr Psychiatry Rep 8:383-8
Suh, Jesse J; Pettinati, Helen M; Kampman, Kyle M et al. (2006) The status of disulfiram: a half of a century later. J Clin Psychopharmacol 26:290-302
Pettinati, Helen M; O'Brien, Charles P; Rabinowitz, Amanda R et al. (2006) The status of naltrexone in the treatment of alcohol dependence: specific effects on heavy drinking. J Clin Psychopharmacol 26:610-25
Dundon, William; Lynch, Kevin G; Pettinati, Helen M et al. (2004) Treatment outcomes in type A and B alcohol dependence 6 months after serotonergic pharmacotherapy. Alcohol Clin Exp Res 28:1065-73
Pettinati, Helen M; Dundon, William; Lipkin, Craig (2004) Gender differences in response to sertraline pharmacotherapy in Type A alcohol dependence. Am J Addict 13:236-47
Pettinati, Helen M (2004) Antidepressant treatment of co-occurring depression and alcohol dependence. Biol Psychiatry 56:785-92
Pettinati, Helen M; Kranzler, Henry R; Madaras, Julie (2003) The status of serotonin-selective pharmacotherapy in the treatment of alcohol dependence. Recent Dev Alcohol 16:247-62
Pettinati, Helen M; Monterosso, John; Lipkin, Craig et al. (2003) Patient attitudes toward treatment predict attendance in clinical pharmacotherapy trials of alcohol and drug treatment. Am J Addict 12:324-35

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