The Treatment of Psychiatric Comorbidity in Alcoholics
Comorbid psychiatric disorders may contribute to the devel-opment or maintenance of heavy drinking. Efforts to treat the comorbidity may have beneficial effects on drinking outcomes. Following detoxification, many alcoholics complain of persistent anxiety, insomnia and general distress. These symptoms may last for weeks or months and may be difficult to differentiate from the emergence of diagnosable psychiatric disorders. Irrespective of their etiology, negative emotional states, including frustration, anger, anxiety, depression and boredom, have been shown to con-tribute to relapse in a substantial proportion of alcoholics.
A variety of medications have been employed to treat comorbid psychiatric symptoms and disorders in alcoholics. In-dications for the use of these medications in alcoholics are similar to those for nonalcoholic populations, but there is added potential for adverse effects due to comorbid medical disorders and the pharmacokinetic effects of acute and chronic alcohol consump-tion. The use of these medications in alcoholics therefore entails additional considerations that can only be arrived at through careful psychiatric diagnosis.