Domenic Ciraulo, MD, chair of psychiatry at Boston University School of Medicine (BUSM) and David H. Barlow, PhD, professor of psychology at Boston University (BU), have collaborated to study the effect of behavioral and medication treatments on patients with alcoholism and anxiety.
The findings, published in the journal Behaviour Research and Therapy, suggest that Transdiagnostic cognitive behavioral therapy (CBT) was more effective in reducing heavy drinking in anxious alcoholics than progressive muscle relaxation therapy (PMR). They also found that the addition of medication to either CBT or PMR participants did not decrease their alcohol consumption.
Participants were divided into four groups; one receiving the antidepressant Venlaflaxine coupled with CBT, one receiving Venlaflaxine with PMR, and the other groups receiving a placebo coupled with either CBT or PMR. After 11 weeks the participants in the group receiving a placebo and CBT alone reported their heavy drinking had significantly decreased when compared to the other groups receiving treatment.
"It is vital to find better treatments, whether they are medication therapies or behavioral interventions," said Ciraulo, principal investigator of the study. "This study points to the importance of behavioral approaches to decrease heavy drinking through strategies to improve emotional regulation."
According to the researchers, while anti-depressant medications may help to control anxious feelings, the ability to acknowledge and respond to such intense feelings may be one reason that CBT is effective. This may be why the addition of an anti-depressant to CBT did not lead to improved outcomes.
"The goal of Transdiagnostic CBT in this study was not to directly treat the specific anxiety symptoms of each anxiety disorder, but rather teach broad skills to cope with emotional issues that underlie a cluster of internalizing (mood and anxiety) disorders that often accompany alcoholism and may contribute to its onset and maintenance," said Barlow co-author of the study.
- Domenic A. Ciraulo, David H. Barlow, Suzy Bird Gulliver, Todd Farchione, Sandra B. Morissette, Barbara W. Kamholz, Katherine Eisenmenger, Bonnie Brown, Eric Devine, Timothy A. Brown, Clifford M. Knapp. The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders. Behaviour Research and Therapy, 2013; 51 (11): 729 DOI: 10.1016/j.brat.2013.08.003
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