Symptoms of anxiety and depression are common in a large proportion of
alcohol-abusing/dependent individuals during alcohol detoxification. The
aim of this study was to examine the impact of a combined
psychotherapeutic-psychopharmacological (either with mirtazapine or
venlafaxine) treatment of these symptoms during the earl), withdrawal
phase of alcohol compared to a group treated only with psychotherapy. A
total of 60 alcohol-dependent/abusing subjects randomly assigned to
three groups (psychotherapy, psychotherapy plus mirtazapine,
psychotherapy plus venlafaxine) were studied. Assessment of
psychopathology and global functioning throughout a 4-5-week
detoxification period was done by the Hamilton Anxiety Rating Scale
(HARS), the Hamilton Depression Rating Scale (HDRS). and the Global
Assessment Scale (GAS). At baseline, high scores of anxiety and
depression were recorded (HARS: controls: 33.1 +/- 7.8. mirtazapine:
33.2 +/- 12.6, venlafaxine: 36.6 +/- 5.4; HDRS: controls: 39.5 +/- 7.4,
mirtazapine: 37.9 +/- 7.8. venlafaxine: 41.9 +/- 4.5). A marked
improvement patients on mirtazapine improved significantly more
(p<0.000) was evidenced in all groups by the end of the detoxification
period. However patients compared to the other two groups (HARS:
controls: 9.6 +/- 7.6, mirtazapine: 4.3 +/- 4.4*. venlafaxine: 7.2 +/-
4.1. *p=0.011; HDRS: controls: 8.6 +/- 7.9, mirtazapine: 3.8 +/-
3.2*, venlafaxine: 8.2 +/- 3.5, *p=0.017; GAS: controls: 79.5 +/-
9.4. mirtazapine: 87.5 +/- 5.5**. venlafaxine: 83.0 +/- 8.0,
**p=0.006). It is concluded that addition of mirtazapine, but not
venlafaxine. to a standard psychotherapy-oriented alcohol detoxification
treatment may facilitate the detoxification process by minimizing
psychological discomfort. Consequently. it may prove to be a facilitator
for the long-term abstinence from alcohol. (C) 2004 Elsevier Inc. All
rights reserved
