McGrath P J, Nunes E V, Stewart J W, Goldman D, Agosti V, Ocepek-Welikson K, Quitkin F M
New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY. USA.
Arch Gen Psychiatry. 1996 Mar;53(3):232-40. doi: 10.1001/archpsyc.1996.01830030054009.
Depressive disorders are commonly comorbid with alcoholism, particularly in treatment-seeking samples. If antidepressant treatment were safe and improved the treatment outcome in the subset of actively drinking alcoholics with depression, this would be of clinical importance.
We conducted a randomized, 12-week placebo-controlled trial of imipramine hydrochloride combined with weekly relapse prevention psychotherapy. The subjects were 69 actively drinking alcoholic outpatients with current depressive disorders. The first onset of depression 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.
Imipramine treatment was safe and associated with improvement in depression in both adequately treated and intention-to-treat samples. While there was no overall effect on drinking outcome, patients whose mood improved showed decreased alcohol consumption that was more marked in those treated with imipramine.
Imipramine treatment is effective for primary depression among actively drinking alcoholic outpatients, and may improve alcoholic outcome for those whose depression responds to treatment.
抑郁障碍常与酒精中毒共病，尤其是在寻求治疗的样本中。如果抗抑郁治疗对患有抑郁症的积极饮酒的酗酒者亚组是安全的且能改善治疗结果，那将具有临床重要性。
我们进行了一项为期12周的随机、安慰剂对照试验，将盐酸丙咪嗪与每周一次的预防复发心理治疗相结合。研究对象为69名患有当前抑郁障碍的积极饮酒的门诊酗酒者。抑郁症的首次发作要么先于酒精滥用，要么发生在长期戒酒期间。测量了12周时的抑郁和饮酒结果及其关系。
在充分治疗和意向性治疗样本中，丙咪嗪治疗是安全的且与抑郁改善相关。虽然对饮酒结果没有总体影响，但情绪改善的患者饮酒量减少，在接受丙咪嗪治疗的患者中更为明显。
丙咪嗪治疗对积极饮酒的门诊酗酒者的原发性抑郁有效，且可能改善那些抑郁症对治疗有反应者的酗酒结果。
