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

Ahmed M Alsheikh,Maryam Osama Elemam,Manal El-Bahnasawi

doi:10.7759/cureus.11168

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.

Highlights

BackgroundSubstance use disorder (SUD) is a condition that is prevalent in all age groups at all socio-economic levels [1]
Regarding the type of abuse, alcohol dependence with depression was evaluated in six studies [16,17,18,20,21,22] either alone or with other abused substances
The present review demonstrated that pharmacological treatment alone might not lead to sufficient outcomes of depression treatment in patients with alcohol dependence or SUDs

Summary

Introduction

Substance use disorder (SUD) is a condition that is prevalent in all age groups at all socio-economic levels [1]. It has been defined as using a psychoactive agent, which results in high levels of stress and functional disabilities [2]. This disorder has been reported as a primary factor for disability globally. It has been estimated that up to 40% of patients with depression have a history of SUD or alcohol dependence during their lifetime [4]. Some data are available on stimulant agents and benzodiazepines [6]

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Conclusion