No studies have been done on the differential efficacy of antidepressants in cocaine-induced depression or comorbid depression in cocaine abusers. Studies have been done on the use of antidepressants for cocaine dependence, that is, their use in the withdrawal of cocaine. Meta-analyses don’t show any significant benefit from the use of antidepressants. It must be said that there aren’t many studies looking at this question and of these, most were done with desipramine, which suggests they’re rather dated. It also seems that there’s no difference in effect between different classes of antidepressant. For instance, despite the action of buproprion on dopamine, there’s no suggestion that it’s more effective than any other antidepressant.

These findings suggest that the approach to treatment of depression in cocaine abusers should be the same as with any depression and that cocaine abuse needs to be treated separately but concurrently.

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