Mecamylamine for Treatment of People With Dual Diagnoses of Depression and Alcohol Dependence

Objective: Currently there is no consensus on the best treatment for individuals with dual diagnoses of alcohol dependence and depression. The aim of this study was to assess the efficacy of mecamylamine augmentation of an antidepressant in reducing drinking, smoking, and depressive symptoms. Methods: This was a double-blind, randomized 12-week treatment trial comparing mecamylamine to placebo. Twenty-one participants with diagnosed alcohol dependence and comorbid depression were included in this study. Eleven participants were assigned to mecamylamine and ten were assigned to placebo. The main outcome variables included drinking measures and depressive symptoms. Analyses included all participants. Results: Mecamylamine augmentation was effective in reducing drinking outcomes particularly in nonsmokers. Symptoms of depression decreased for all participants and there was a trend indicating that this was more pronounced again for nonsmokers receiving mecamylamine. The rates of smoking decreased for all smokers. There were no significant differences in the rates of side effect reporting between those receiving mecamylamine and those receiving placebo or smokers versus nonsmokers. Conclusions: Mecamylamine was more effective than placebo in reducing drinking in nonsmokers. The data regarding depressive symptoms and smoking need further study. This study is registered on www.clinicaltrials.gov under number NCT00563797.