Developing therapies for depression in drug dependence: results of a stage 1 therapy study

This Stage 1b controlled trial sought a preliminary test of the relative efficacy of Behavioral Therapy for Depression in Drug Dependence (BTDD) against a structured relaxation intervention (REL) for treating DSM-IV depressive disorders and substance abuse.

Thirty-eight methadone maintained opiate dependent participants, who met criteria for a DSM-IV depressive disorder, were randomized to one of two, 24-week treatment conditions (BTDD or REL).

Depression response, defined as at least a 50% reduction in Hamilton Depression Scale score from baseline to the end of study, was high and similar in both BTDD (61%) and REL (65%). Rates of drug use were low overall, both at baseline and at the end of study, and did not differ between treatment groups at study endpoint.

The findings suggest that both behavioral- and relaxation-based approaches show promise for treating comorbid depression in drug dependent populations. Future work should examine combining or modifying these interventions to target substance use more directly and include values based methods for increasing more adaptive behavioral patterns.