Combination Therapy for Alcohol Dependence and Depression

Depression and alcohol dependence often go hand in hand. Sometimes a depressed individual will turn to drugs or alcohol as a form of self-medication. In other cases, excessive drinking results in a mental state of depression. No matter which condition precedes the other, the result is nearly always the same. An alcohol-dependent, depressed individual is notoriously unresponsive to treatment, particularly when that treatment fails to address both conditions. When only the problem drinking is treated, lingering depression may lead to relapse of drinking. When only depression is treated, excess alcohol intake disrupts the action of medications. Few studies exist on the potential benefits of combination therapy, despite the heavy burden of alcoholism and comorbid depression.

One of the first of its kind, the drug Depade (naltrexone) is approved for the treatment of alcohol and other drug dependence. When taken correctly, Depade reduces the amount of alcohol consumed. It also helps the recovering alcoholic maintain abstinence. The medication works by reducing the reward sensations, thereby reducing the craving for alcohol. However, that’s only one part of a complicated puzzle. Cognitive behavioral therapy is likewise important for identifying causes and triggers for drinking. Without some form of intervention and social support, medication alone is nearly useless, as many studies have shown.

Previous research has indicated that relatively high doses of a selective serotonin reuptake inhibitor are necessary for the treatment of depression with alcoholism. A recent multisite study tested the safety and effectiveness of a combination of Zoloft (sertraline) with Depade. Participants were randomized to four groups: Zoloft plus Depade; Zoloft plus placebo; Depade plus placebo; and both placebo. All groups received weekly sessions of cognitive behavioral therapy. As the research team had hoped, the combination group displayed the greatest improvement on all significant outcome measures. Combination therapy yielded longer abstinence periods, lower drinking quantities, and better scores on standard depression rating scales. Even more promising was the fact that combination therapy resulted in no more adverse events than placebo.

The long-term prognosis for untreated alcohol dependence is grim. Deteriorating physical and psychosocial health are inevitable results of uncontrolled drinking. Severe depression makes abstinence and recovery even more difficult. A combination therapy that addresses both drinking and mood is therefore favored. According to the most recent clinical knowledge, Depade and Zoloft, when combined with intensive cognitive behavioral therapy, offer a safe and effective pathway out of depression and addiction.


  1. Pettinati, H. M., Oslin, D. W., Kampman, K. M., Dundon, W. D., Xie, H., Gallis, T. L., et al. (2010). A double blind, placebo-controlled trial that combines sertraline and naltrexone for treating co-occurring depression and alcohol dependence. American Journal of Psychiatry, 167(6), 668-675.
  2. PubMed Health. (n.d.). National Center for Biotechnology Information. Sertraline. Retrieved April 6, 2012, from


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