Does a history of alcohol use disorder affect response to antidepressant medication in patients with dysthymic disorder?

Background: Research on the relationship between depression and alcohol use disorder in remission has been scarce. The authors examined whether a lifetime history of alcohol use disorder affected response to antidepressant treatment of dysthymic disorder (DD) in adult outpatients. Methods: This is a secondary analysis of data from previous prospective medication trials. Data from 123 subjects with DD were included. Subjects were categorized into 2 groups: (1) no lifetime alcohol use disorder (NLAUD) (n = 99) and (2) lifetime alcohol use disorder (LAUD) (n = 24). None of the subjects met criteria for alcohol use disorder for 6 months prior to intake. Rating scales from baseline and after 8 weeks of pharmacotherapy were collected. Results: After 8 weeks of treatment, the NLAUD and LAUD groups did not differ in rates of response or remission, despite significantly higher baseline Hamilton Depression Rating Scale (HDRS)-24 scores in the LAUD group. We also found a greater decrease in symptoms in the LAUD group, as measured by the HDRS-24. Conclusions: Our preliminary findings suggest that DD in remitted alcoholics is at least as responsive to pharmacotherapy as DD in nonalcoholics and support adequate evaluation and treatment of DD in remitted alcoholic patients. 2008 by The Haworth Press. All rights reserved.