Medical Health Encyclopedia

Depression is common among alcohol-dependent people, and it can be a significant problem in people who quit drinking. In fact, one 2002 study found that quitting drinking was associated with a fourfold increase in the risk for major depression. Antidepressants may be helpful, particularly for patients who have a history of depression. Experts reporting on the study suggested that treating these individuals with antidepressants as soon as they quit drinking may help prevent relapse. A 2004 review of clinical trials found that antidepressants had a limited effect on alcohol dependence and should be prescribed in combination with behavioral or pharmacologic therapies that directly address the addiction itself.

SSRIs. Selective serotonin reuptake inhibitors (SSRIs) target the neurotransmitter serotonin and are of particular interest in the treatment of alcoholism. They include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and fluvoxamine (Luvox). Studies indicate that these antidepressants may reduce cravings and desire for alcohol, even in selected people who are not depressed. Studies report reductions in alcohol ranging from 10 - 70% in people with alcoholism who take SSRIs. Research is under way to determine which individuals with alcoholism might best respond to SSRIs. For example, one study suggested that they may be more effective for men than women. Some may be specifically helpful for people with both alcoholism and certain anxiety disorders, such as social anxiety.

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Designer Antidepressants. A number of drugs have now been developed that target other neurotransmitters, such as norepinephrine, alone or in addition to serotonin. They include nefazodone (Serzone), venlafaxine (Effexor), and mirtazapine (Remeron). Some research suggests they may have some benefits for treating alcoholism. However, nefazodone has been linked to increased risk for liver damage and should be used with caution by people with alcohol dependence.

Other Drugs