Pharmacological Treatment of Alcohol Abuse/Dependence With Psychiatric Comorbidity

Abstract

This article represents the proceedings of a symposium at the 2003 annual meeting RSA in Fort Lauderdale, FL. It was organized and cochaired by Charlene E. Le Fauve and Carrie L. Randall. The presentations were (1) Introduction, by Charlene E. Le Fauve and Raye Z. Litten; (2) Treatment of co-occurring alcohol use and anxiety disorders, by Carrie L. Randall and Sarah W. Book; (3) Pharmacological treatment of alcohol dependent patients with comorbid depression, by Darlene H. Moak; (4) Efficacy of valproate in bipolar alcoholics: a double blind, placebo-controlled study, by Ihsan M. Salloum, Jack R. Cornelius, Dennis C. Daley, Levent Kirisci, Johnathan Himmelhoch, and Michael E. Thase; (5) Alcoholism and schizophrenia: effects of antipsychotics, by Alan I. Green, Robert E. Drake, Suzannah V. Zimmet, Rael D. Strous, Melinda Salomon, and Mark Brenner; and (6) Conclusions, by Charlene E. Le Fauve; discussant, Raye Z. Litten. Alcohol-dependent individuals have exceptionally high rates of co-occurring psychiatric disorders. Although this population is more likely to seek alcoholism treatment than noncomorbid alcoholics, the prognosis for treatment is often poor, particularly among patients with more severe psychiatric illnesses. Development of effective interventions to treat this population is in the early stages of research. Although the interaction between the psychiatric condition and alcoholism is complex, progress has been made. The NIAAA has supported a number of state-of-the-art pharmacological and behavioral trials in a variety of comorbid psychiatric disorders. Some of these trials have been completed and are presented here. The symposium presented some new research findings from clinical studies with the aim of facilitating the development of treatments that improve alcohol and psychiatric outcomes among individuals with alcohol-use disorders and co-occurring psychiatric disorders. The panel focused on social anxiety disorder, depression, bipolar disorder, and schizophrenia.

Abstinence following Alcohol Drinking Produces Depression-Like Behavior and Reduced Hippocampal Neurogenesis in Mice

“…There are only a limited number of well-controlled clinical studies on the efficacy of antidepressant use for alcoholics (Ostacher, 2007). Clinical studies have demonstrated that antidepressants are effective in reversing depression comorbid with alcoholism, and have shown modest success in preventing relapse (Le Fauve et al, 2004). As mentioned above, depression that occurs during abstinence has been linked to an increased risk of relapse (Hasin et al, 2002).…”

Psychopathy and Axis I psychiatric disorders among criminal offenders: relationships to impulsive and proactive aggression

“…Taken together, findings regarding GAD, PTSD, and alcohol use disorder suggest the importance of assessing these clinical conditions among criminal offenders as a way to potentially minimize the risk for IA. Such assessment may be especially useful given that there are effective pharmacological and psychosocial treatments for these conditions [Barlow, 2007;Borkovec and Ruscio, 2001;Le Fauve et al, 2004;Moyer et al, 2002] that can be applied in criminal justice settings. Effective intervention for GAD, PTSD, and alcohol use disorder may reduce negative affective states including anger that increase the likelihood of IA.…”

Neonatal amygdala lesions: Co-occuring impact on social/fear-related behavior and cocaine sensitization in adult rats.

“…Further studies using the NAML may be useful for understanding addiction vulnerability in the mentally ill or interpreting clinical data suggesting that history of chronic substance use alters neuropsychiatric illness trajectories and treatment responsiveness (Le Fauve et al, 2004). Experimental time line with respect to rat age.…”