<html>

<head>
<title></title>
</head>

<body>

<p>NewsstandResourcesAsk&nbsp;MayoWhat's&nbsp;Hot<br>
</p>

<p><br>
</p>

<p>Brought to you by Mayo ClinicMay 23, 1998<br>
</p>

<p>Alcoholism and Depression<br>
Antidepressants can help<br>
May 1 1996<br>
For decades, people who were alcoholic and depressed have confounded physicians <br>
and other treatment professionals. These people raised troubling questions with <br>
few answers. <br>
&quot;It can be difficult to diagnose clinical depression, to know if it's a true <br>
depression or just a constellation of unhappiness,&quot; says Patricia L. Owen, PhD, <br>
director of the Butler Center for Research and Learning at the Hazelden <br>
Foundation, Center City, Minn. Dr. Owen is also author of I Can See Tomorrow: A <br>
Guide for Living With Depression . Owen says health care professionals have <br>
wrestled with the dilemma of how to treat alcoholism when it comes bundled with <br>
depression. &quot;Should you just let nature run its course, hoping that the <br>
depression will lift as the alcoholism recovery process gets underway?&quot; asks <br>
Owen. &quot;Or is it better to vigorously treat depression in these instances with <br>
medication and therapy?&quot; <br>
A study reported in the March 13, 1996, issue of the Journal of the American <br>
Medical Association (JAMA) provides some answers. The study indicated the drug <br>
desipramine can safely and effectively relieve major depression in alcoholics. <br>
Study raises larger issues<br>
The JAMA report touched on profound issues for alcoholics and health care <br>
providers. Thirty to 40 percent of alcoholics may relapse, that is, return to <br>
problem drinking within one year after treatment. Also, alcoholics are at risk <br>
for mental health problems including schizophrenia, anxiety disorders, and major <br>
depression. Finally, the symptoms of depression and alcohol withdrawal mimic <br>
each other, making it hard to separate the two conditions. <br>
Misconceptions cloud treatment<br>
Also complicating the treatment picture are three common misconceptions : <br>
Alcoholics Anonymous (AA) and other self-help groups prohibit <br>
antidepressants. <br>
Antidepressants are mood-altering and intoxicating. <br>
Antidepressants are addictive. <br>
None of these statements are true. An AA pamphlet titled &quot;The AA <br>
Member--Medication and Other Drugs&quot; addresses the need for some alcoholics to <br>
take antidepressive drugs such as desipramine. In addition, desipramine is <br>
neither intoxicating nor addictive. <br>
Method and results of the study<br>
The authors of the JAMA article studied 71 alcoholics, dividing their subjects <br>
into four groups: <br>
Those who were depressed and took desipramine. <br>
Those who were depressed and took a placebo. <br>
Those who were not depressed and took desipramine. <br>
Those who were not depressed and took a placebo. <br>
This was a double-blind study. Neither the patients nor the treatment providers <br>
knew which alcoholics received desipramine and which the placebo. All subjects <br>
were in outpatient psychiatric treatment, and all had abstained from alcohol for <br>
at least one week before the study. <br>
The researchers found that, after six months, the depressed alcoholics who took <br>
desipramine experienced significantly greater relief from depression. (&quot;Relief&quot; <br>
was defined as a lower score on the Hamilton Depression Rating Scale, a <br>
psychological inventory.) And overall, the recovering alcoholics who took <br>
desipramine stayed abstinent from alcohol longer than those who took the <br>
placebo. <br>
Implications for treatment<br>
&quot;This study indicates that it's possible to make a fairly accurate diagnosis of <br>
depression after a week of abstinence from alcohol and take a reasonable <br>
approach to treating depression,&quot; says Dr. Owen. At treatment centers such as <br>
Hazelden, this approach combines medication with alcoholism treatment, therapy <br>
and AA attendance. &quot;There's little research that's been done specifically on <br>
recovering alcoholics and depression, so the JAMA study is very helpful,&quot; Owen <br>
adds. <br>
Emotional/Mental Health &amp; Sexuality | Medicines | May Index<br>
<br>
<br>
<br>
</p>

<p>© 1996 Mayo Foundation for Medical Education and Research. All rights reserved. <br>
Materials copyrighted by Mayo may be reprinted for personal use only. Permission <br>
to reprint or electronically reproduce any document in part or in its entirety <br>
for any other reason is expressly prohibited, unless prior written consent is <br>
obtained form Mayo. &quot;Mayo Health O@sis,&quot; &quot;Mayo,&quot; &quot;Mayo
Clinic,&quot; and the <br>
triple-shield Mayo logo are marks of Mayo Foundation and are used under license <br>
by Mayo Foundation for Medical Education and Research. <br>
<br>
<br>
</p>

<p>LEGAL RESTRICTIONS AND TERMS OF USE APPLICABLE TO THIS SITE <br>
USE OF THIS SITE SIGNIFIES YOUR AGREEMENT TO THE TERMS OF USE.<br>
© 1995-1998, content, Mayo Foundation for Medical Education and <br>
Research.<br>
</p>
</body>
</html>