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Physical & Mental Disorder Comorbidity in Substance Users - page 21 / 40

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Management principles where patient continues to use alcohol

Alcohol dependence:

Motivational interviewing to encourage reduction in alcohol or abstinence

Depression:

Education about relationship of alcohol and depression

Use of antidepressants

Little evidence that antidepressants reduce alcohol intake

Antidepressants do help with symptoms of depression, but on-going alcohol use remains a perpetuating factor for depression

Avoid tricyclic antidepressants (overdose risk)

SSRIs have most evidence of efficacy

Cognitive Behavioural Interventions

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