Depressive disorders and substance use disorders are the most common dual pathologies in the substance abuse field. It is difficult to establish whether the depressed state is induced or rather independent of substance use and/or abuse, therefore, making the therapeutic approach more complex. This article presents the state of the art of the currently available pharmacologic treatments of comorbid depression in patients with alcohol, cocaine, heroin, and tobacco dependence disorders, thus emphasizing the safety and tolerability of various antidepressant drugs. Finally, it is also aimed to call attention on the appropriate recommendations for the use of antidepressants in patients with this dual pathology.
*Institute of Neuropsychiatry and Addiction (INADs)
†Department of Psychiatry, Universitat Autònoma de Barcelona, Barcelona
‡Servicio Psiquiatría, Hospital Virgen de la Torre, Madrid, Spain
§Department of Psychiatry & behavioural Sciences, University of Miami Miller School of Medicine, Miami, FL
Support by the “Fondo de Investigaciones Sanitarias de la Seguridad Social,” FIS PS09/02121, and the “Instituto Carlos III” (RTA 06/0001/1009), and Brain-Pharma.
The funding organizations had no role in the design, preparation, interpretation of the data, and review or approval of the study.
Reprints: Marta Torrens, MD, PhD, Instituto de Neuropsiquiatria I Adiccions (INAD), Parc de Salut Mar, Passeig Maritim, 25-29, Barcelona 08003 Spain (e-mail: MTorrens@hospitaldelmar.cat).