Lithium Treatment of Depressed and Nondepressed Alcoholics

Abstract

We assessed the efficacy of lithium carbonate in the treatment of 457 male alcoholics in a double-blind, placebo-controlled Department of Veterans Affairs Cooperative Study. Alcoholics either without depression or with a history of major depression, current major depression, or dysthymic disorder were studied. Two hundred eighty-six alcoholics without depression and 171 alcoholics with depression began the 52-week outpatient study; 172 alcoholics (60.1%) without depression and 108 alcoholics (63.2%) with depression completed the study. Among both all alcoholics who began the study and a subgroup who completed the study, no significant differences between alcoholics who took lithium and those who took placebo were found for the following outcome measures:number of alcoholics abstinent, number of days of drinking, number of alcohol-related hospitalizations, changes in rating of severity of alcoholism, and change in severity of depression. Similarly, no significant differences were found when only the 82 alcoholics compliant in taking lithium and the 89 alcoholics compliant in taking placebo were considered. In our study, lithium treatment did not affect the course of alcoholism in either depressed or nondepressed alcoholics.

Depression in patients with alcohol use disorders: Systematic review and meta-analysis of outcomes for independent and substance-induced disorders

“…Follow-up completion rates in these studies ranged from 48 to 93% (median 70%). The remaining 6 studies (Altintoprak et al, 2008;Dorus et al, 1989;Janiri et al, 1996;Mason et al, 1996;Paparrigopoulos et al, 2010;Petrakis et al, 2007) were excluded from the meta-analysis because their reported outcomes were not clearly identified as relating to the intention-to-treat sample.…”

Treatments for Patients With Dual Diagnosis: A Review

“…In addition to antidepressants, other medications have also been tested with depressed alcoholic patients. Alcoholic patients, with or without depression, were randomized to receive either lithium or placebo (Dorus et al, 1989). No significant difference was found between the 2 groups on many depressive and alcohol outcome measures.…”

Naltrexone for the treatment of alcoholism: a meta-analysis of randomized controlled trials

“…drinking frequency and amount of alcohol consumption (Garbutt et al, 1999). While the results of some studies showed that lithium reduced drinking in alcohol-dependent patients with mood disorders (Fawcett et al, 1984;Merry et al, 1976), a randomized controlled trial (RCT) failed to demonstrate any benefit of this drug in either depressed or non-depressed patients (Dorus et al, 1989). The efficacy of selective serotonin reuptake inhibitors (SSRIs) remains to be tested in placebo-controlled, randomized trials with large sample sizes.…”