Letter	Pharmacopsychiatry 2005; 38: 100-102 DOI: 10.1055/s-2005-837812
© Georg Thieme Verlag KG Stuttgart · New York
Naltrexone Treatment of Combined Alcohol and Opioid Dependence: Deterioration of Co-morbid Major Depression
A Case Report
M. Schürks1, M. Overlack2, U. Bonnet2
1 Department of Neurology, University of Duisburg-Essen, Essen, Germany 2 Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany

Naltrexone is frequently used for the treatment of opioid or alcohol dependence. However, the reports on its potential to worsen affective disorders are contradicting. Here we report on a patient with combined alcohol and opioid dependence whose co-morbid major depression deteriorated reversibly and repeatedly under naltrexone. By exchanging buprenorphine for naltrexone, his depression and craving for alcohol and opioids disappeared. This underlines the close interaction between depression, substance dependence and the opioid system.