Treatment of Depression With Alcohol and Substance Dependence: A Systematic Review

Abstract

Although alcohol and/or substance use disorders have been significantly associated with depression, data on the treatment outcomes of depression in this patient population are still scarce, especially among the higher risk of resistance to treatment. This study examines the management outcomes of depression in patients with alcohol and substance dependence during the last decade by searching the medical literature. The literature was searched through Medline, PsycInfo, Embase, and Ovid database from 2010 to 2020. Searching terms included were a combination of ‘’treatment’’ AND ‘’Depression’’ AND ‘’alcohol’’ OR “substance abuse". A total of 617 articles were retrieved. After this, original articles investigating depression treatment outcomes in patients with alcohol or substance use disorders or both were selected. Following the exclusion of review studies and including only original research studies, 23 articles appeared. We selected eight articles as eligible, covering a total of 132,373 patients with depression and either alcohol dependence or substance use disorder. Anti-depressants (mainly selective serotonin reuptake inhibitors) combined with psychotherapy and alcohol or substance abuse treatment represent the best treatment modality for depression in this clinical setting. In conclusion, patients with alcohol or substance dependence usually suffer from treatment-resistant depression. However, the treatment of depressive symptoms would help in substance or alcohol abstinence and reduce recurrent substance abuse.

Spatial characteristics of non-communicable diseases and their associations to social conditions in a large urban cohort in Germany—Results from the Hamburg City Health Study

“…The relationship between alcohol use and depression is also complex, and the results here cannot be clearly related to the literature. Although it is estimated that up to 40% of people with depression have had a lifetime history of addiction or alcohol dependence [ 37 ], this does not provide a clear link.…”

Prevalence and associated factors of depression in Sri Lanka: a systematic review and meta-analysis

“…Moreover, smoking and alcohol use were associated with depression across the subgroups. Worldwide studies have shown that comorbid substance use, especially alcohol use, is closely associated with depression [ 69 , 70 ]. In Sri Lanka, old age and addiction psychiatry subspecialty services are at a rudimentary level, and combined substance and mood disorder management would be a more pragmatic approach.…”

Group cognitive behavioral therapy as an effective approach for patients with alcohol dependence: A perspective study

“…It is clearly demonstrated that many people will relapse to drinking following the treatment. [1] A study showed that more than 80% of patients with AD also experience other mental illnesses, such as anxiety, depression, and antisocial personality disorder. [17] After a period of treatment, if patients with AD drink again, all symptoms of withdrawal syndrome will reappear quickly.…”

“…Further, these are often prioritized over other essential activities, resulting in mental, physical, and social impairment of individuals. [1] AD has a high recurrence rate without an effective treatment. [2] However, targeted interventions can play a positive role in preventing relapse based on the investigation and analysis of high-risk factors that cause patients with AD to relapse.…”