This study will assess whether individuals treated with sertraline (Zoloft) and cognitive behavior therapy will experience improvement with their depression and consume less alcohol than individuals treated with a placebo and cognitive behavior therapy. This is a 12-week, random assignment, placebo-controlled, double-blind study with followup assessments 1 and 3 months after treatment.

Ages Eligible for Study:  18 Years   -   65 Years,  Genders Eligible for Study:  Both

Criteria

Inclusion Criteria:

• Meets criteria for major depressive episode.
• Meets criteria for alcohol abuse or dependence thirty days prior to entering the study.
• Has had no more than one previous inpatient medical detoxification.
• Able to maintain sobriety for ten days.
• Able to read and understand questionnaires and informed consent.
• Lives within 50 miles of the study site, has a stable living situation, and a reliable source of collateral reporting.

Exclusion Criteria:

• Meets criteria for any other psychoactive substance dependence other than nicotine.
• Any psychoactive substance abuse (other than nicotine or marijuana) within 30 days before beginning of study.
• Meets criteria for other psychiatric disorders including: panic disorder, obsessive-compulsive disorder, bipolar affective disorder, cyclothymia, schizophrenia, any organic mental disorder, eating disorder, dissociative disorder, or post-traumatic stress disorder.
• Has evidence of treatment resistant depression defined as more than one previous treatment episode for depression, which can include hospitalization and/or one course of antidepressant medication.
• Patients may not have been prescribed a specific serotonergic medication within the month prior to study and may not have taken any antidepressant or antipsychotic within the two weeks prior to study.
• Current use of disulfiram (Antabuse) or anti-seizure medications.
• Clinically significant medical problems: cardiovascular, renal, gastrointestinal, or endocrine problems that would limit participation or limit medication ingestion.
• Hepatocellular disease.
• Females who are pregnant, nursing, or not using a reliable form of birth control.
• Current charges pending for violent crime (excluding DUI related offenses).
• Previous adverse experience with a serotonin reuptake inhibitor.
• Current homicidal or suicidal ideation.