(HealthDay News) – Treatment of major depressive disorder (MDD) in adolescents can reduce the likelihood of subsequent substance use disorders (SUD), but does not reduce alcohol use disorders (AUD).

Jon Curry, PhD, from the Duke University Medical Center in Durham, NC, and colleagues followed 192 adolescents who had participated in the Treatment for Adolescents with Depression Study (TADS). Participants had no previous AUD or SUD diagnosis and were allocated to cognitive behavior therapy, fluoxetine, a combination of therapy and fluoxetine, or placebo. Patients were assessed using the TADS treatment response rating and a more restrictive symptom count rating. Over five years of follow-up, interviews were completed at six- or 12-month intervals to assess AUD or SUD onset as well as MDD recovery and recurrence.

The researchers found that, regardless of the measure of positive response, achieving a positive response to treatment predicted a lower rate of subsequent SUD but was unrelated to subsequent AUD. Neither outcome was affected by the type of initial MDD treatment. Later AUD or SUD was predicted by greater involvement with alcohol or drugs prior to depression treatment, older age (for AUD), and more comorbid disorders (for SUD). AUD preceded MDD recurrence in 24 of 25 cases with recurrent MDD and AUD.

“Effective short-term adolescent depression treatment significantly reduces the rate of subsequent SUD but not AUD,” the authors write. “Alcohol or drug use should be assessed prior to adolescent MDD treatment and monitored even after MDD recovery.”

Several authors disclosed financial ties to Eli Lilly, which manufactures fluoxetine.

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