Alsheikh Ahmed M, Elemam Maryam O, El-Bahnasawi Manal
Medicine, College of Medicine, Almaarefa University, Riyadh, SAU.
Pharmacy, Dr. Sulaiman Al-Habib Medical Group, Riyadh, SAU.
Cureus. 2020 Oct 26;12(10):e11168. doi: 10.7759/cureus.11168.
Although alcohol and/or substance use disorders have been significantly associated with depression, data on the treatment outcomes of depression in this patient population are still scarce, especially among the higher risk of resistance to treatment. This study examines the management outcomes of depression in patients with alcohol and substance dependence during the last decade by searching the medical literature. The literature was searched through Medline, PsycInfo, Embase, and Ovid database from 2010 to 2020. Searching terms included were a combination of ''treatment'' AND ''Depression'' AND ''alcohol'' OR "substance abuse". A total of 617 articles were retrieved. After this, original articles investigating depression treatment outcomes in patients with alcohol or substance use disorders or both were selected. Following the exclusion of review studies and including only original research studies, 23 articles appeared. We selected eight articles as eligible, covering a total of 132,373 patients with depression and either alcohol dependence or substance use disorder. Anti-depressants (mainly selective serotonin reuptake inhibitors) combined with psychotherapy and alcohol or substance abuse treatment represent the best treatment modality for depression in this clinical setting. In conclusion, patients with alcohol or substance dependence usually suffer from treatment-resistant depression. However, the treatment of depressive symptoms would help in substance or alcohol abstinence and reduce recurrent substance abuse.
尽管酒精和/或物质使用障碍与抑郁症显著相关，但关于该患者群体抑郁症治疗结果的数据仍然匮乏，尤其是在治疗抵抗风险较高的人群中。本研究通过检索医学文献，考察了过去十年中酒精和物质依赖患者抑郁症的治疗结果。通过Medline、PsycInfo、Embase和Ovid数据库检索2010年至2020年的文献。检索词包括“治疗”、“抑郁症”、“酒精”或“物质滥用”的组合。共检索到617篇文章。此后，选择了调查酒精或物质使用障碍患者或两者兼有的抑郁症治疗结果的原始文章。在排除综述研究并仅纳入原始研究后，出现了23篇文章。我们选择了8篇符合条件的文章，共涵盖132373名患有抑郁症且伴有酒精依赖或物质使用障碍的患者。抗抑郁药（主要是选择性5-羟色胺再摄取抑制剂）联合心理治疗以及酒精或物质滥用治疗是这种临床情况下抑郁症的最佳治疗方式。总之，酒精或物质依赖患者通常患有难治性抑郁症。然而，抑郁症状的治疗有助于物质或酒精戒断，并减少复发性物质滥用。
