The purpose of this study is to evaluate the impact of treating depression on substance dependent teens.

The primary study aim is to determine whether fluoxetine + CBT is a more effective treatment than placebo + CBT for substance outcomes, depression, and behavior problems. The current community standard of care often withholds pharmacotherapy for depression in substance abusing adolescents, since it is often assumed that their depressions may remit with SUD treatment alone. However, this is an untested hypothesis in adolescents and one that we propose to test in the current study.

Ages Eligible for Study:  13 Years   -   19 Years,  Genders Eligible for Study:  Both

Criteria

Inclusion Criteria:

• Must have DSM IV non bipolar Major Depressive disorder (by clinical interview), DSM IV Conduct Disorder, and Non-Tobacco Substance Disorder.

Exclusion Criteria:

• History of or current psychosis, history of psychotic depression, bipolar disorder I or II, family history of first degree relative with bipolar I, lifetime history of non-substance induced Mania/Hypomania
• Unstable chronic or serious medical illness
• Currently pregnant
• Take psychotrophic medication, past 2 months: medication or treatment for depression, clinically significant laboratory abnormality