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depression in patients with substance abuse
Pathology:
- depression linked to inflammation in adolescents [3]
Management:
1) transient depression may resolve with abstinence from substance abuse
2) 6 trials show no benefit in treating depression in patients enrolled in substance abuse treatment programs
3) alcoholics with depression may benefit from combination treatment with:
a) SSRI
b) naltrexone
c) cognitive behavioral therapy (CBT) [2]
4) a healthy diet consisting of more fish, fruits, vegetables, whole grains associated less depression
General
depression
References
- Journal Watch 24(11):87, 2004
Nunes EV, Levin FR.
Treatment of depression in patients with alcohol or other drug
dependence: a meta-analysis.
JAMA. 2004 Apr 21;291(15):1887-96. Review.
PMID: 15100209
- Pettinati HM et al.
A double-blind, placebo-controlled trial combining sertraline
and naltrexone for treating co-occurring depression and
alcohol dependence.
Am J Psychiatry 2010 Mar 15; [e-pub ahead of print]
PMID: 20231324
http://dx.doi.org/10.1176/appi.ajp.2009.08060852
- Joffe A
Does a Healthy Diet Protect Against Depression in Adolescence?
NEJM Journal Watch. Jan 26, 2018
Massachusetts Medical Society
(subscription needed) http://www.jwatch.org
- Oddy WH, Allen KL, Trapp GSA et al.
Dietary patterns, body mass index and inflammation: Pathways
to depression and mental health problems in adolescents.
Brain Behav Immun 2018 Jan 12;
PMID: 29339318
https://www.sciencedirect.com/science/article/pii/S0889159118300023