Sertraline plus naltrexone for treating co-occuring depression and alcohol dependence

January 01, 0001

Sertraline plus naltrexone for treating co-occuring depression and alcohol dependence

These US authors provide results from a double-blind, placebo-controlled trial that evaluated the efficacy of combining approved medications for depression (sertraline) and alcohol dependence (naltrexone) in treating patients with both disorders. A total of 170 depressed alcohol- dependent patients were randomly assigned to receive 14 weeks of treatment with sertraline (200 mg/day, N=40), naltrexone (100 mg/day, N=49), the combination of sertraline plus naltrexone (N=42), or double placebo (N=39) while receiving weekly cognitive-behavioral therapy.

They found: "The sertraline plus naltrexone combination produced a higher alcohol abstinence rate (53.7%) and demonstrated a longer delay before relapse to heavy drinking (median delay=98 days) than the naltrexone (abstinence rate: 21.3%; delay=29 days), sertraline (abstinence rate: 27.5%; delay=23 days), and placebo (abstinence rate: 23.1%; delay=26 days) groups. The number of patients in the medication combination group not depressed by the end of treatment (83.3%) approached significance when compared with patients in the other treatment groups. The serious adverse event rate was 25.9%, with fewer reported with the medication combination (11.9%) than the other treatments."

The authors concluded: "More depressed alcohol-dependent patients receiving the sertraline plus naltrexone combination achieved abstinence from alcohol, had delayed relapse to heavy drinking, reported fewer serious adverse events, and tended to not be depressed by the end of treatment."

A larger study is needed to demonstrate whether the combination provides improved remission of depression.

For the full abstract, click here.

Am J Psychiatry 167:668-675, June 2010 © 2010 American Psychiatric Association
A Double-Blind, Placebo-Controlled Trial Combining Sertraline and Naltrexone for Treating Co-Occurring Depression and Alcohol Dependence. Helen M. Pettinati, David W. Oslin, Kyle M. Kampman, et al. Correspondence to Dr. Pettinati: [email protected]

Category: P. Psychological. Keywords: depression, alcohol dependence, treatment, abstinence, sertraline, naltrexone, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 15 June 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.