Adolescents with substance use disorders (SUD) and conduct disorder (CD) have high rates of comorbid depression. Despite the high prevalence of depression in such youth, little is known about effective treatment of such depressions. Moreover, the effects of treating depression on substance use and other problem behaviors in such youth are not known. Only serotonergic agents, fluoxetine (FLX) and paroxetine, with most support for FLX, have empirical support in the treatment of depression in adolescents without serious comorbidity. It is not known whether FLX (or paroxetine) are effective in treating the depressions of adolescents with SUD and CD. The proposed study is a randomized, placebo-controlled trial comparing placebo to fluoxetine for major depressive disorder (MDD) in 120 adolescents with SUD and CD. Adolescents with DSM-1V SUD, CD, and MDD assessed both clinically and with structured assessment instruments, will be randomized to one of these two treatment cells for 16 weeks. All subjects will also receive standardized, manual-driven cognitive behavior treatment for adolescent SUD for the duration of the trial as the background """"""""treatment as usual"""""""" Medication compliance will be electronically monitored. Adverse side effects will be monitored weekly.
The specific aims of this study are to test the following hypotheses: 1. Fidoxeline + CBT will be more effective in treating unipolar depression in adolescents with SUD and CD than placebo + CBT. 2. The treatment of depression with RX + CBT, in depressed adolescents with SUD and CD will be more effective than placebo + CBT in reducing substance use and improving conduct symptoms. 3. The treatment of depression with RX will result in greater retention in, and compliance with substance treatment (CBT) and reduction in both substance use and conduct problems than treatment with placebo. This research will contribute important knowledge regarding effective treatment of depression in conduct-disordered adolescents with SUD and provide information about the effects of treating depression on substance and other behavioral outcomes as well.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA013176-02
Application #
6379013
Study Section
Special Emphasis Panel (ZDA1-MXV-P (10))
Program Officer
Montoya, Ivan
Project Start
2000-09-30
Project End
2005-07-31
Budget Start
2001-09-01
Budget End
2002-07-31
Support Year
2
Fiscal Year
2001
Total Cost
$543,852
Indirect Cost
Name
University of Colorado Denver
Department
Psychiatry
Type
Schools of Medicine
DUNS #
065391526
City
Aurora
State
CO
Country
United States
Zip Code
80045
Riggs, Paula; Levin, Frances; Green, Alan I et al. (2008) Comorbid psychiatric and substance abuse disorders: recent treatment research. Subst Abus 29:51-63
Riggs, Paula D; Thompson, Laetitia L; Tapert, Susan F et al. (2007) Advances in neurobiological research related to interventions in adolescents with substance use disorders: research to practice. Drug Alcohol Depend 91:306-11
Thurstone, Christian; Riggs, Paula D; Klein, Constance et al. (2007) A one-session human immunodeficiency virus risk-reduction intervention in adolescents with psychiatric and substance use disorders. J Am Acad Child Adolesc Psychiatry 46:1179-86
Riggs, Paula D; Mikulich-Gilbertson, Susan K; Davies, Robert D et al. (2007) A randomized controlled trial of fluoxetine and cognitive behavioral therapy in adolescents with major depression, behavior problems, and substance use disorders. Arch Pediatr Adolesc Med 161:1026-34
Libby, Anne M; Orton, Heather D; Stover, Shannon K et al. (2005) What came first, major depression or substance use disorder? Clinical characteristics and substance use comparing teens in a treatment cohort. Addict Behav 30:1649-62
Libby, Anne M; Riggs, Paula D (2005) Integrated substance use and mental health treatment for adolescents: aligning organizational and financial incentives. J Child Adolesc Psychopharmacol 15:826-34
Riggs, Paula D (2003) Treating adolescents for substance abuse and comorbid psychiatric disorders. Sci Pract Perspect 2:18-29