The Effects of At-Risk Drinking on the Treatment of Late Life Major Depression: A Pilot Study to Establish Effects

ABSTRACT

Objectives. Depression is one of the leading causes of morbidity and mortality worldwide. Comorbidity with alcohol dependence is a significant cause of poor response to treatment for depression and prolonged disability. However, epidemiological evidence demonstrates that at-risk alcohol use (drinking more than 1 drink/day and not meeting criteria for alcohol dependence) is more common than alcohol dependence among patients with major depression and that this is especially true in mid and late life.

Methods: Patients with a depressive disorder were enrolled in one of two clinical trials and received standard depression care. Outcomes were compared amongst those patients who drank at or above recommended drinking limits to those who were non-drinkers.

Results: Patients from both studies who consumed alcohol at levels considered “at-risk” have had lower rates of remission from standard depression care. While these results were not statistically significant, they provide a framework for conceptualizing a more definitive trial.

Conclusion: These data suggest that at-risk drinking may reduce the effectiveness of standard depression care. Therefore, assessment of alcohol use and intervention at lower levels of drinking may be of value in increasing the impact of depression care.

KEYWORDS:

• Alcohol misuse
• depression
• treatment