Anhedonia as target symptom in personalized therapy of patients with mood disorders and alcohol use disorder comorbidity

Abstract

To estimate the efficacy of antidepressants in the treatment of anhedonia in mood disorders (MD) comorbid with alcohol use disorder (AUD), considering melatonin concentration in the patient's blood serum. Seventy patients, aged 18-65 years old, with MD, including patients with- (group F3+F10, n=36) or without comorbid AUD (group F3, n=34), were examined. Control group consisted of 26 healthy volunteers. Clinical-dynamic evaluation was carried out using SIGH-SAD and SHAPS-C. Melatonin concentration was measured with MAGPIX analyzer (Luminex, USA). The statistical analysis was carried out using the SPSS (V. 23.0) standard package. In the case of MD/AUD comorbidity anhedonia symptom does not respond well to psychopharmacotherapy during four weeks (p=0.192, Wilcoxon test) whereas anhedonia in «pure» MD does (p=0.007, Wilcoxon test). At the same time, only patients with «pure» MD have a statistically significant decrease in melatonin concentration in blood serum compared with the control group (p=0.025, p=0.031, Mann-Whitney test), on the contrary, in the case of MD/AUD comorbidity, a relative increase in melatonin concentration (p>0.05 Mann-Whitney test) was demonstrated. The relatively low response of anhedonia symptom in the case of MD/AUD comorbidity compared with the «pure» MD, makes perspective using antidepressants with prodophaminergic mechanism of action in this cohort of patients. Furthermore, in MD/AUD comorbidity, contrary to «pure» MD, a relative increase in melatonin concentration in blood serum was detected, therefore it could be a limitation to prescribing antidepressants directly or indirectly modulating melatoninergic system.