Nefazodone treatment of comorbid alcohol dependence and major depression.
BACKGROUND
Major depression is a common comorbid condition among individuals with alcohol dependence. This study examined the effects of nefazodone, a norepinephrine and serotonin reuptake blocker and 5-hydroxytryptamine-2 receptor antagonist, on mood and anxiety symptoms and drinking behavior in a sample of depressed alcoholics.


METHODS
This study was a double-blind, placebo-controlled comparison of nefazodone (200-600 mg/day) or placebo in a sample of alcohol-dependent subjects (n = 41; 52% women) with current major depression. After a 1-week placebo lead-in period, subjects were randomly assigned to receive study medication and supportive psychotherapy for 10 weeks.


RESULTS
Depressive and anxiety symptoms declined significantly over time. Although the nefazodone group showed greater reductions in these symptoms, the effects did not reach statistical significance. Nonetheless, nefazodone-treated subjects showed a significantly greater reduction in heavy drinking days and in total drinks compared with placebo-treated subjects.


CONCLUSIONS
The lack of significant effects on depression and anxiety symptoms may reflect limited statistical power. Despite the small sample size, nefazodone significantly reduced some measures of alcohol consumption in this sample of depressed alcoholics.
Hernandez-Avila
Carlos A
CA
Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Modesto-Lowe
Vania
V
Feinn
Richard
R
Kranzler
Henry R
HR
D000328:Adult; D000437:Alcoholism / Q000188:drug therapy* / Q000523:psychology*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines; D014230:Triazoles / Q000627:therapeutic use*
D010879:Piperazines; D014230:Triazoles; C051752:nefazodone