The antidepressant fluoxetine combined with cognitive behavioral therapy appears as effective for treating depression among teens that also have substance use disorders as among those without substance abuse problems, according to a report in the November issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
“Adolescents with substance use disorders (SUDs) have higher rates of depression (15 percent to 24 percent) than adolescents in the general population,” the authors write as background information in the article. “Comorbid [co-occurring] depression is also associated with more severe substance abuse, poorer drug treatment outcomes and higher relapse rates.”
Paula D. Riggs, M.D., and colleagues at the
At the end of the 16-week treatment period, fluoxetine combined with cognitive behavioral therapy improved the teens’ scores on one of the two depression scales used. There were no significant differences on the other depression scale or in substance use or conduct disorder symptoms between the fluoxetine and placebo groups.
The results, the authors write, “indicate that, in the context of cognitive behavior therapy (substance abuse treatment), co-occurring depression may improve or remit without antidepressant pharmacotherapy. However, if depression does not appear to be improving early in the course of substance treatment, fluoxetine treatment should be considered, even if adolescents are not yet abstinent, with weekly monitoring of treatment adherence, substance use, adverse effects and target symptom response.”
Arch Pediatr Adolesc Med. 2007; 161(11):1026-1034