Depressed patients are considered to be more vulnerable to developing alcohol abuse or dependence, as these individuals may self-medicate with drugs or alcohol to attempt to gain some temporary relief from their depressive symptoms. In a review of the literature, Lori L. Davis, M.D., with the Veterans Affairs (VA) Medical Center, and her colleagues found that nearly one-third of patients had co-occurring major depressive disorder (MDD) and substance use disorders (SUDs).
The high prevalence of comorbid depression and substance abuse contributes to a higher risk of suicide, greater social and functional impairment and other mental health problems — including anxiety and worsening symptoms of depression — among these individuals. The use of alcohol or drugs to lessen the negative effects of stress, anxiety or other physical or mental health problems can also contribute to the development of addiction (alcoholism), and alcohol and drug-related problems.
Despite the high comorbidity between alcohol abuse and depression, relatively few treatment options take this fact into account. In addition, the need for researchers is increasing to identify effective treatment alternatives to antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), as fewer people are responding well, if at all, to these medications, rendering these depressed individuals as treatment-resistant.
Novel treatments for depression
Ketamine is a well-established anesthetic drug that has emerged as a novel therapy for treatment-resistant depression and works by blocking the N-methyl-D-aspartate (NMDA) receptors in the brain. Unlike antidepressants that may take several months to begin working, the use of ketamine acts faster and has the potential to provide patients with rapid relief from depressive disorders. Ketamine reversed depressive-like behaviors induced by alcohol withdrawal in a mouse model, according to a recent study published in the journal Neuropsychopharmacology.
The researchers from Vanderbilt University administered ethanol alcohol (EtOH) to mice who exhibited depressive-like behaviors following a two-week abstinence period, evidenced by their behavior in the forced swim test (FST). After the depression-like behavior was established, the affective disturbance was long lasting — the mice exhibited depressive-like behaviors 35 days after alcohol withdrawal in the novelty-suppressed feeding test (NSFT).
The researchers also found that the endocannabinoid system may play an important role in depression. When they used an enzyme monoacylglycerol (MAG) lipase inhibitor to raise the levels of an endogenous cannabinoid called 2-arachidonoyl glycerol (2-AG), the MAG lipase inhibitor had a similar effect to ketamine in reversing symptoms of depression following alcohol withdrawal.
Utilizing the endocannabinoid system
An estimated 30 to 40 percent of people who seek treatment for depression do not get better or fully recover with standard antidepressants — these individuals are at a much greater risk of developing problems with alcohol and drugs, being hospitalized and attempting suicide. In line with previous research, the present study supported earlier studies that have found ketamine to be useful for treating depression. Importantly, the researchers also reversed mood disturbances using a MAG lipase inhibitor that binds to endogenous cannabinoid receptors. Researchers may use the role that the endocannabinoid system plays in anxiety and depression to develop novel and more effective treatment options for patients with depressive disorders.
Sovereign Health of Florida provides evidence-based behavioral treatment options for patients with substance abuse, mental illness and co-occurring disorders. For more information on the treatment of co-occurring depression and alcohol addiction or about Sovereign Health of Florida’s treatment programs, please contact our 24/7 helpline to speak to a member of our team.
About the author
Amanda Habermann is a writer for the Sovereign Health Group. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. She brings to the team her background in research, testing and assessment, diagnosis and recovery techniques. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.
Sovereign Health Group is a leading addiction, dual diagnosis and mental health treatment provider. Call our admissions team 24 hours a day, 7 days a week to get the help you deserve.