Evidence map›Paper›PMID 37467796›Full record

ArticleJournal of affective disorders2023

Treatment outcomes in major depressive disorder in patients with comorbid alcohol use disorder: A STAR*D analysis.

Victor M Tang, Dengdeng Yu, Cory R Weissman, Brett D M Jones, Guan Wang, Matthew E Sloan, Daniel M Blumberger, Zafiris J Daskalakis, Bernard Le Foll, Daphne Voineskos

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of affective disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.7field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Major depressive disorder-alcohol use disorder comorbidity: diagnosis, mechanisms and treatment.European archives of psychiatry and clinical neuroscience · 2026
    Review
  2. Article
  3. Review
  4. Article
  5. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024
    Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 2 countries.

Victor M TangDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Dengdeng YuDepartment of Mathematics, University of Texas at Arlington, Arlington, TX, USA.
Cory R WeissmanDepartment of Psychiatry, UC San Diego Health, La Jolla, CA, USA; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
Brett D M JonesDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Guan WangBiostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Matthew E SloanDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Daniel M BlumbergerDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Zafiris J DaskalakisDepartment of Psychiatry, UC San Diego Health, La Jolla, CA, USA.
Bernard Le FollDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada.
Daphne VoineskosDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Poul Hansen Family Centre for Depression, Krembil Research Institute, Toronto Western Hospital, University Health Network, Canada. Electronic address: daphne.voineskos@camh.ca.
University of Toronto · CAUC San Diego Health System · USCentre for Addiction and Mental Health · CAThe University of Texas at Arlington · USToronto Western Hospital · CAWaypoint Centre for Mental Health Care · CA

Funding

Advancing Clinical Research Training within Addiction Residency ProgramsR25DA033211 · NIDA · BOSTON MEDICAL CENTER · PI Patrick O'Connor, JEFFREY H. SAMET · 2012 to 2026
$4.2M
NIDA NIH HHS R25 DA033211
6 · The paper itself

Abstract

introductionGuidance on Major Depressive Disorder (MDD) treatment in those with comorbid Alcohol Use Disorder (AUD) is limited. We performed a secondary analysis on the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, examining the association between comorbid AUD and depression outcomes.

methodsSTAR*D was a real-world effectiveness trial starting with citalopram in level 1. Non-responding participants progressed through 3 other sequential treatment levels with different switch or augmentation options. Antidepressant outcomes were compared between MDD (n = 2826) and comorbid MDD and AUD (n = 864). Logistic regressions were performed to evaluate remission and response predictors in the total STAR*D sample and the AUD-comorbidity interaction.

resultsChi-squared tests showed no significant difference in response or remission rates from depression between groups across treatment levels. Higher Hamilton Rating Scale for Depression (HRSD) score was associated with overall lower odds of remission in treatment level 1 (OR = 0.93, p < 0.001) and 2 (OR = 0.95, p < 0.001), with no significant interaction with comorbid AUD. Higher baseline suicidality had overall lower odds of remission in level 1 (OR = 0.82, p < 0.001) and 2 (OR = 0.1, p < 0.001), but with comorbid AUD compared to no AUD, suicidality increased odds of level 1 remission (OR = 1.30, p = 0.012). In comorbid AUD in level 2, venlafaxine was associated with lower odds of remission (OR = 0.13, p = 0.013) and response (OR = 0.12, p = 0.006); bupropion with lower odds of response (OR = 0.22, p = 0.024). LIMITATIONS: Open label study design and lack of alcohol use data.

conclusionsComorbid AUD may interact with predictors of antidepressant response in MDD and using venlafaxine or bupropion may be less effective. Addressing this comorbidity requires unique assessment and treatment approaches.

Indexed as

AlcoholismMajor Depressive DisorderAntidepressive AgentsBupropionComorbidityHumansTreatment OutcomeVenlafaxine HydrochlorideAntidepressive AgentsBupropionVenlafaxine HydrochlorideAlcohol Use DisorderAntidepressantsComorbidityMajor Depressive Disorder

Identifiers

PMID37467796
PMCPMC10496139
OpenAlexW4384564790

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.