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Three classes of intervention have sufficient evidence to warrant their consideration for policy and practice recommendations

• The available evidence suggests potentially actionable benefits at postintervention of cognitive behavioral therapy for depressive symptoms, tricyclic antidepressants for depressive symptoms, and selective serotonin reuptake inhibitors (SSRIs) for total drinking and functional status.
• SSRIs also have higher risks of adverse events (including serious adverse events).

The authors had very low confidence in most effect estimates, primarily due to sparse networks with limited data

• The authors identified significant effects for several other comparisons but have very limited confidence to support their consideration for policy and practice recommendations on the basis of evidence on effectiveness.
• Most bodies of evidence included only indirect evidence or direct evidence from single studies with small sample sizes.
• Notably, numerous clinical interventions contained in clinical practice guidelines for either depression or alcohol use disorder are missing from the current body of evidence on patients with both disorders.

More pragmatic, preregistered, and well-reported randomized controlled trials are needed, particularly on clinical interventions recommended for patients with either a depressive or alcohol use disorder

Alcohol use disorders (AUDs) and depressive disorders are prevalent, and a significant number of people are diagnosed with both. Identifying effective treatments for patients with co-occurring AUDs and depressive disorders is important, given the potential severity of symptoms and the negative societal consequences of ineffective treatment. The purpose of this review is to synthesize evidence on the effects and compare the effectiveness of clinical interventions for improving symptoms of adults with co-occurring AUDs and depressive disorders. The review aims to support clinical decisionmaking regarding which interventions to use with patients dually diagnosed with co-occurring AUD and depressive disorders.

• Chapter One

  Introduction

• Chapter Two

  Methods

• Chapter Three

  Results

• Chapter Four

  Discussion

• Appendix A

  Electronic Search Strategies

• Appendix B

  Eligible Diagnoses

• Appendix C

  Studies Ongoing or Waiting Assessment

• Appendix D

  Included Studies

• Appendix E

  Network Geometry

• Appendix F

  Sensitivity Analyses