The study of effectiveness of antidepressant and acamprosate to the depressive patients with alcohol use disorders

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Masaya T1,2,3, Toshikazu S1,2
1 Psychiatry Institute, Hokujinkai Medical Corporation, Japan
2 Miki mental clinic, Japan
3 Department of Neuropsychiatry, School of Medicine, Sapporo Medical University, Japan

Background
Patients of Alcohol use disorder have many problems not only in drinking but also in physical, mental, and social conditions.
Especially, Alcohol use disorders and depression shows a high rate of comorbidity.
In that case, it is considered that the two diseases have mutually bad influence and exacerbate their symptoms each other. As a result, therapeutic effect show poor outcomes and induce the increase of suicide risk and the decrease of effectiveness of antidepressant and sleeping drug. Therefore in this study, we have investigated the therapeutic effect of the cases using Acamprosate.

Method
Depression symptoms and alcohol problems of participants were assessed a by using 17 items Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory (BDI) and The Alcohol Use Disorders Identification Test (AUDIT). Those whose the HAM-D score was less than 14 at first visit our clinic were excluded.
The subjects were divided into 3 groups: Depression group (AUDIT score < 12, without Acamprosate), Non-Acamprosate group (AUDIT score ≧20,without Acamprosate) and Acamprosate group (AUDIT score ≧20,with Acamprosate).
The effect of medication on depressive symptoms was monitored over 12 weeks using HAM-D and BDI.

Results
There was no significant difference between each group of HAM-D score at the first visit of our clinic. However, significant differences were observed at 8 week and 12 week. Depression group and Acamprosate group showed significant improvement in HAM-D score through the study period. In contrast,
No significant improvement was observed in Non-Acamprosate group.

Conclusion
These result suggested that it is important to abstain from alcohol drinking for improvement to depressive symptom in Alcohol use disorder. In addition, it would be possible that Acamprosate itself has an antidepressant-like action.

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