The Use of Antidepressants in Alcohol-Dependent Veterans
J Clin Psychiatry 2003;64(8):865-870
© Copyright 2015 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Although some research reports
suggest antidepressants may be an effective treatment for alcohol
dependence, their clinical use has been controversial.
Method: By using comprehensive national
administrative data from the Department of Veterans Affairs (VA)
documenting psychiatric diagnoses and care under natural
conditions in both mental health and non-mental health settings,
the use of antidepressants was compared in alcoholic and
non-alcoholic veterans. Data were collected from April 1, 2000,
to Sept. 30, 2000.
Results: Overall, patients with alcohol
dependence were significantly more likely to be prescribed
antidepressants than individuals without alcoholism (38.9% vs.
31.2%), but multivariate analysis showed that this was
attributable to the higher rate of comorbid psychiatric diagnoses
in this group. After controlling for diagnosis and other
potentially confounding factors, alcohol-dependent individuals
treated in specialty mental health clinics were in fact less
likely to be prescribed antidepressants (odds ratio = 0.95, p
< .0001). Of patients treated with antidepressants, those with
alcohol dependence were more likely to be prescribed newer
antidepressants (odds ratio = 1.22, p < .0001). Among patients
treated in non-mental health clinics, there were no significant
differences in rate of antidepressant use between
alcohol-dependent and non-alcohol-dependent individuals with
mental illness after controlling for other factors.
Conclusion: The principal finding is that a
diagnosis of alcoholism, independent of other factors, is
associated with a decreased likelihood of receiving
antidepressant treatment in VA mental health clinics, suggesting
that prescribers have not embraced reports of their efficacy in
alcohol dependence. In fact, this may reflect a disinclination to
use medications to treat alcoholism in specialty mental health
clinics but not in non-mental health clinics.