Treatment of depression in drug-dependent patients: effects on mood and drug use.

Symptoms of depression and anxiety are common in patients with substance use disorders (Meyer 1986; Schuckit 1986). In the general population, mood and anxiety disorders convey increased risk for substance use disorders (Regier et al. 1990). Further, mooddisordered substance abusers have poor prognoses (Rounsaville et al. 1982b, 1986b, 1987; Weissman et al. 1976; Kosten et al. 1986; LaPorte et al. 1981; Loosen et al. 1990; Carroll et al. 1993). Thus, evaluation and appropriate management of affective disorders should be a useful treatment adjunct with the potential of improving outcome of substance abuse. Nevertheless, controversy continues to surround this clinical problem, and approaches vary widely among clinicians.