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Alcohol use by Female Veterans Receiving Antidepressant Therapy

Cretzmeyer MT, Mengeling M, Sadler AG, Torner J, Booth B. Alcohol use by Female Veterans Receiving Antidepressant Therapy. Paper presented at: VA HSR&D Field-Based Women's Health Meeting; 2010 Jul 16; Washington, DC.

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Objectives: The 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel cites rates of heavy drinking at 20%, a rate which is significantly higher than civilians (14%) and almost 2% higher than the 2005 DoD survey. Heavy drinking is defined as consuming five or more drinks (four for females) on the same occasion at least once a week in the past 30 days. Rates by gender were 8.3% for female and 21.9% for male service members. The survey also identified a greater percentage of women with depression screening scores than males (25.6% v 20.3%). Prior research has identified an association of heavy drinking among non-military females with depression, regardless of antidepressant intervention. This study examined drinking patterns among a sample of female veterans by depression diagnosis, antidepressant medication use, and hazardous alcohol consumption patterns. Methods: This research was a retrospective cross-sectional study of women Veterans enrolled at the Iowa City, Des Moines Veterans Administration Medical Centers or their outlying clinics within the 5 years preceding research interview. Consenting subjects (N = 1004) completed a telephone interview assessing demographics, lifetime sexual assaults, and health risks and care including mental health diagnoses and alcohol use. Data on alcohol use was collected using the Substance Abuse Outcomes Module (SAOM). Depression was assessed using the World Health Organization Composite International Diagnostic Interview short-form (CIDI SF) depression scale. Antidepressant use was identified by self report. Results: Overall, subjects with a diagnosis of depression reported drinking more on days they drank than those with no diagnosis of depression, regardless of antidepressant medication intervention. Analysis conducted by depression and antidepressant use found that among those who reported hazardous drinking, those diagnosed depressed and taking antidepressants averaged almost six drinks on drinking days as compared to the average of 4.48 (drinks on drinking days) by all other hazardous drinkers in the sample. The average number of drinks on drinking days for the entire sample was 1.31 drinks. Conclusions: depression and substance use disorders and similar results have been found in this study of female veterans. The risk of consuming alcohol while taking antidepressant medication has been well documented. Research has shown that counsel from a health care provider can influence drinking behavior. VA health care professionals working with this population need to be aware of these co-occurring behaviors and provide female veteran patients with adequate information on the risks of alcohol consumption while undergoing antidepressant medication therapy. The impact of heavy drinking while on antidepressant medication has significant clinical implications. Impacts: Women seeking VA health care have specific environment of care concerns and needs. To meet the needs of a priority care MST population, differences in environment and resources are required to provide optimal care for women veterans.

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