Achieving abstinence by treating depression in the presence of substance-use disorders

Addictive Behaviors
Morten Hesse

Abstract

Antidepressants can have an effect on depressive symptoms in participants with comorbid drug or alcohol dependence and mood disorder, but their effect on drug use is not known. It has been suggested that adding psychosocial intervention to antidepressants would enhance the effect on drug use. A meta-analysis was conducted on trials of antidepressants for this comorbidity with and without psychosocial treatment. Studies using cognitive-behavioural therapy (CBT) found no medication effect, whereas with no intervention, medication was superior to placebo, manualised counselling falling in between. There is no evidence that antidepressant medication is more efficacious in reducing drug use with conjunctive psychosocial treatment. Antidepressant medication and psychotherapy may both be useful in the treatment of substance-dependent depressed patients, but combining psychotherapy and medication may only be useful in patients failing to respond to one treatment.

References

Jun 1, 1993·The American Journal of Psychiatry·E V NunesK Ocepek-Welikson
Mar 1, 1996·Archives of General Psychiatry·P J McGrathF M Quitkin
Nov 1, 1996·Journal of Substance Abuse Treatment·G P GallowayD Smith
Aug 1, 1997·Archives of General Psychiatry·J R CorneliusA Black
Jul 3, 1998·Drug and Alcohol Dependence·I PetrakisB Rounsaville
Jun 22, 2001·Drug and Alcohol Dependence·J M SchmitzJ Grabowski

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Citations

Jan 1, 2006·Mens Sana Monographs·Morten Hesse
Apr 17, 2014·The Cochrane Database of Systematic Reviews·Morten HesseMats Fridell
Feb 2, 2020·BMC Public Health·Morten HesseJens Christoffer Skogen
Oct 30, 2020·The American Journal of Psychiatry·Lara N CoughlinLewei A Lin

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