New onset alcohol dependence linked to treatment with selective serotonin reuptake inhibitors.

Background: Genetic and environmental factors influence the development of alcohol dependence and alcohol dependence increases the risk of developing Major Depressive Disorder-MDD (vice versa). Amongst antidepressants, the selective serotonin reuptake inhibitors (SSRIs) are likely the most frequently prescribed for MDD. However, findings on the role of SSRIs in alleviating alcoholism are conflicting.

Case Description: A review of the literature is highlighted with a case of middle-aged lady with new onset alcohol dependence syndrome after commencement of SSRI, which resolved following discontinuation of the SSRIs and the introduction of Mirtazapine.

Discussion: The serotonin transporter gene has been linked to excessive drinking, early-onset problem drinking, alcohol dependence, anxiety and impulsiveness. While the evidence for antidepressant use appears consistent in alleviating depressive symptoms in patients with comorbid alcohol dependence and depression, some groups of patients may show an increase in alcohol consumption. Alternatively, there are a series of studies suggesting that antagonism of S-3 receptors can lead to diminished cravings for alcohol. This case highlights the need for further research into the effects of SSRIs on alcohol consumption in those with and without previous alcohol dependence syndromes. It also indicates a need to monitor changes in alcohol consumption and behaviour while on SSRIs.