PRELIMINARY-REPORT - DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF FLUOXETINE IN DEPRESSED ALCOHOLICS

The selective serotonergic agonist fluoxetine has demonstrated efficac y in the treatment of depression and has possible efficacy in the trea tment of nondepressed and depressed alcoholics. However, no double-bli nd, placebo-controlled trials with any selective serotonergic medicati on have been reported in patients who have both major depression and a lcoholism. In this study, 21 patients with DSM-III-R diagnoses of both major depressive disorder and alcohol dependence were randomized to f luoxetine or placebo in a 12-week, double-blind, parallel group trial. The patients reported a high level of current episode (52.4%), prior episode (61.9%), and lifetime (76.2%) suicidal behavior. Total alcohol consumption during the 12-week treatment course was significantly low er in the fluoxetine group than the placebo group, after controlling f or baseline differences in consumption. The fluoxetine group demonstra ted a four-fold greater improvement in depressive symptoms, but this d ifference did not reach statistical significance in this small sample. These preliminary findings suggest that fluoxetine has potential for treating the excessive alcohol ingestion of depressed alcoholics and m ay have potential for treating the depressive symptoms of these patien ts as well.