Antidepressants for the treatment of people with co-occurring depression and alcohol dependence

Abstract

BackgroundAlcohol dependence is a major public health problem characterized by recidivism, and medical and psychosocial complications. The cooccurrence of major depression in people entering treatment for alcohol dependence is common, and represents a risk factor for morbidity and mortality, which negatively influences treatment outcomes. ObjectivesTo assess the benefits and risks of antidepressants for the treatment of people with co-occurring depression and alcohol dependence. Search methodsWe searched the Cochrane Drugs and Alcohol Group Specialised Register (via CRSLive), Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase from inception to July 2017. We also searched for ongoing and unpublished studies via ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (apps.who.int/ trialsearch/).All searches included non-English language literature. We handsearched references of topic-related systematic reviews and the included studies. Selection criteriaRandomized controlled trials and controlled clinical trials comparing antidepressants alone or in association with other drugs or psychosocial interventions (or both) versus placebo, no treatment, and other pharmacological or psychosocial interventions. Data collection and analysisWe used standard methodological procedures as expected by Cochrane. Main resultsWe included 33 studies in the review (2242 participants). Antidepressants were compared to placebo (22 studies), psychotherapy (two studies), other medications (four studies), or other antidepressants (five studies). The mean duration of the trials was 9.9 weeks (range 3 to 26 weeks). Eighteen studies took place in the USA, 12 in Europe, two in Turkey, and one in Australia. The antidepressant included in most of the trials was sertraline; other medications were amitriptyline, citalopram, desipramine, doxepin, escitalopram, fluoxetine, fluvoxamine, imipramine, mianserin, mirtazepine, nefazodone, paroxetine, tianeptine, venlafaxine, and viloxazine. Eighteen studies were conducted in Antidepressants for the treatment of people with co-occurring depression and alcohol dependence (Review)

Association of Apelin and Apelin Receptor Polymorphisms With the Risk of Comorbid Depression and Anxiety in Coronary Heart Disease Patients

“…Additionally, patients with CHD who has alcohol drinking habits were less likely to have depression than were non-drinkers. This finding, however, deviates from previously published results, which suggested a causal relationship between alcohol use disorders and major depression ( Agabio et al, 2018 ). Moreover, patients with CHD who had more complications were more likely to have depression or anxiety, which may be explained by the additional psychological stress that these patients experience.…”

Association of Apelin and Apelin Receptor Polymorphisms With the Risk of Comorbid Depression and Anxiety in Coronary Heart Disease Patients

“…Additionally, patients with CHD who has alcohol drinking habits were less likely to have depression than were non-drinkers. This finding, however, deviates from previously published results, which suggested a causal relationship between alcohol use disorders and major depression ( Agabio et al, 2018 ). Moreover, patients with CHD who had more complications were more likely to have depression or anxiety, which may be explained by the additional psychological stress that these patients experience.…”

Factors associated with fluoxetine and norfluoxetine plasma concentrations and clinical response in Mexican patients with mental disorders

“…The presence of depression has been reported to be more frequent in people with alcohol dependence than in the rest of the population 33 . This is consistent with the positive association found in this study between alcohol consumption and higher depressive scores.…”

“…The presence of depression has been reported to be more frequent in people with alcohol dependence than in the rest of the population. 33 This is consistent with the positive association found in this study between alcohol consumption and higher depressive scores. Moreover, around 20% of the patients with depressive disorders may be refractory to antidepressants at doses considered adequate.…”

TED—trazodone effectiveness in depression: a naturalistic study of the effeciveness of trazodone in extended release formulation compared to SSRIs in patients with a major depressive disorder

“…Third, the inclusion criteria in our trial were stricter than in STAR*D, i.e., we did not include subjects with persistent mood disorder, while in the former study, these patients constituted approximately 25% of the study sample; our observation excluded individuals with substance abuse (other than caffeine of nicotine), while in the STAR*D study, participants with alcohol or drug dependence accounted for nearly 20% of the sample. These factors could explain the differences in the rates of treatment response and remission in our observation, given that a longer duration of depressive symptoms and/or substance abuse are liked to lower treatment effectiveness of antidepressant therapy (Ghio et al, 2014;Agabio et al, 2018). Our results are consistent with the previous findings, suggesting that trazodone (CR or IR) is no less effective than fluoxetine (Falk et al, 1989;Beasley et al, 1991), paroxetine (Kasper et al, 2005), or sertraline (Munizza et al, 2006) in MDD and more beneficial in improving insomnia (Papakostas and Fava, 2007).…”

Association of Apelin and Apelin Receptor Polymorphisms With the Risk of Comorbid Depression and Anxiety in Coronary Heart Disease Patients

“…Additionally, patients with CHD who has alcohol drinking habits were less likely to have depression than were non-drinkers. This finding, however, deviates from previously published results, which suggested a causal relationship between alcohol use disorders and major depression ( Agabio et al, 2018 ). Moreover, patients with CHD who had more complications were more likely to have depression or anxiety, which may be explained by the additional psychological stress that these patients experience.…”

Factors associated with fluoxetine and norfluoxetine plasma concentrations and clinical response in Mexican patients with mental disorders

“…The presence of depression has been reported to be more frequent in people with alcohol dependence than in the rest of the population 33 . This is consistent with the positive association found in this study between alcohol consumption and higher depressive scores.…”

“…The presence of depression has been reported to be more frequent in people with alcohol dependence than in the rest of the population. 33 This is consistent with the positive association found in this study between alcohol consumption and higher depressive scores. Moreover, around 20% of the patients with depressive disorders may be refractory to antidepressants at doses considered adequate.…”

TED—trazodone effectiveness in depression: a naturalistic study of the effeciveness of trazodone in extended release formulation compared to SSRIs in patients with a major depressive disorder

“…Third, the inclusion criteria in our trial were stricter than in STAR*D, i.e., we did not include subjects with persistent mood disorder, while in the former study, these patients constituted approximately 25% of the study sample; our observation excluded individuals with substance abuse (other than caffeine of nicotine), while in the STAR*D study, participants with alcohol or drug dependence accounted for nearly 20% of the sample. These factors could explain the differences in the rates of treatment response and remission in our observation, given that a longer duration of depressive symptoms and/or substance abuse are liked to lower treatment effectiveness of antidepressant therapy (Ghio et al, 2014;Agabio et al, 2018). Our results are consistent with the previous findings, suggesting that trazodone (CR or IR) is no less effective than fluoxetine (Falk et al, 1989;Beasley et al, 1991), paroxetine (Kasper et al, 2005), or sertraline (Munizza et al, 2006) in MDD and more beneficial in improving insomnia (Papakostas and Fava, 2007).…”

Association of Apelin and Apelin Receptor Polymorphisms With the Risk of Comorbid Depression and Anxiety in Coronary Heart Disease Patients

“…Additionally, patients with CHD who has alcohol drinking habits were less likely to have depression than were non-drinkers. This finding, however, deviates from previously published results, which suggested a causal relationship between alcohol use disorders and major depression ( Agabio et al, 2018 ). Moreover, patients with CHD who had more complications were more likely to have depression or anxiety, which may be explained by the additional psychological stress that these patients experience.…”

Factors associated with fluoxetine and norfluoxetine plasma concentrations and clinical response in Mexican patients with mental disorders

“…The presence of depression has been reported to be more frequent in people with alcohol dependence than in the rest of the population 33 . This is consistent with the positive association found in this study between alcohol consumption and higher depressive scores.…”

“…The presence of depression has been reported to be more frequent in people with alcohol dependence than in the rest of the population. 33 This is consistent with the positive association found in this study between alcohol consumption and higher depressive scores. Moreover, around 20% of the patients with depressive disorders may be refractory to antidepressants at doses considered adequate.…”

TED—trazodone effectiveness in depression: a naturalistic study of the effeciveness of trazodone in extended release formulation compared to SSRIs in patients with a major depressive disorder

“…Third, the inclusion criteria in our trial were stricter than in STAR*D, i.e., we did not include subjects with persistent mood disorder, while in the former study, these patients constituted approximately 25% of the study sample; our observation excluded individuals with substance abuse (other than caffeine of nicotine), while in the STAR*D study, participants with alcohol or drug dependence accounted for nearly 20% of the sample. These factors could explain the differences in the rates of treatment response and remission in our observation, given that a longer duration of depressive symptoms and/or substance abuse are liked to lower treatment effectiveness of antidepressant therapy (Ghio et al, 2014;Agabio et al, 2018). Our results are consistent with the previous findings, suggesting that trazodone (CR or IR) is no less effective than fluoxetine (Falk et al, 1989;Beasley et al, 1991), paroxetine (Kasper et al, 2005), or sertraline (Munizza et al, 2006) in MDD and more beneficial in improving insomnia (Papakostas and Fava, 2007).…”