IMIPRAMINE TREATMENT OF ALCOHOLICS WITH PRIMARY DEPRESSION - A PLACEBO-CONTROLLED CLINICAL-TRIAL

Background: Depressive disorders are commonly comorbid with alcoholism , particularly in treatment-seeking samples. If antidepressant treatme nt were safe and improved the treatment outcome in the subset of activ ely drinking alcoholics with depression, this would be of clinical imp ortance. Methods: We conducted a randomized, 12-week placebo-controlle d trial of imipramine hydrochloride combined with weekly relapse preve ntion pschotherapy. The subjects were 69 actively drinking alcoholic o utpatients with current depressive disorders. The first onset of depre ssion was either antecedent to the abuse of alcohol or occurred during prolonged periods of sobriety. Depression and drinking outcomes at 12 weeks, as well as their relationship, were measured. Results: Imipram ine treatment was safe and associated with improvement in depression i n both adequately treated and intention-to-treat samples. While there was no overall effect on drinking outcome, patients whose mood improve d showed decreased alcohol consumption that was more marked in those t reated with imipramine. Conclusions: Imipramine treatment is effective for primary depression among actively drinking alcoholic outpatients, and may improve alcoholic outcome for those whose depression responds to treatment.