Drug That Helps Addicted Teens

Depressed teenagers addicted to drugs improved significantly in a Colorado study that combined intense psychotherapy and an antidepressant called fluoxetine, psychiatrists reported Monday.

The work is the first to show that an antidepressant can be safe and effective for adolescents using illegal drugs, said Paula Riggs, a psychiatrist at the University of Colorado School of Medicine in Aurora and the study's lead author.

It is groundbreaking, she said, because substance-abusing youths have generally been excluded from clinical trials, for fear their drug use would interact with treatment drugs, or they'd fail to show up when required.

About 125 Denver-area adolescents with substance-abuse problems and depression stuck out four months of weekly cognitive behavioral therapy sessions and antidepressant or placebo pills. Most improved, according to the study.

By one measure, depression lifted for 76 percent of teens treated with fluoxetine and 67 percent of teens on the placebo, Riggs and her colleagues reported in today's issue of the Archives of Pediatric and Adolescent Medicine. Fluoxetine is the generic form of Prozac.

To recruit teenagers, Riggs advertised on city buses, took referrals from school counselors and health care experts, and she pulled in 26 kids who had been court-ordered to get substance-abuse treatment.

"I'll never forget my first call - because I was worried they wouldn't come in," Riggs said. "It was 'Yo, Riggs. Luke here. I saw your symptoms on the bus. Page me."'

Mental health treatment facilities insist that teenagers and others abusing drugs get help to deal with that substance abuse before receiving mental health care, she said.

Substance-abuse programs, however, don't work well for teens struggling with depression and other psychiatric issues, Riggs said.

The opposite is also true - substance-abuse programs are often not equipped to handle mental health issues.

Jacques Okonji, director of the Community Alcohol and Drug Rehabilitation and Education Center in Denver, said that when his center finds adolescents also have mental health problems, they are referred to other providers.

In the new study, Riggs and her colleagues found that for those teens whose depression eased, substance abuse declined, whether or not they were on the antidepressant.

The paper also validated the effectiveness of cognitive behavioral therapy - intense, one-on-one therapy sessions often built around discussions of what events trigger certain behaviors, and role-playing to figure out how to respond differently.

The Denver Post