Problem:
A combination of antidepressants and psychotherapy is the best medication therapy for a patient with Major Depressive Disorder (MDD) and a history of alcohol misuse. In patients with a history of alcohol consumption, selective serotonin reuptake inhibitors (SSRIs) are generally used as the first-line therapy for MDD. However, several antidepressants, including tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), can interact with alcohol and raise the risk of side effects; as a result, they need to be avoided by patients who have a history of alcohol consumption. For the antidepressant to take full effect, the patient should see symptom relief in around 4-6 weeks, but the length of treatment for MDD can vary from person to person.