Sertraline and Cognitive Therapy in Depressed Alcoholics

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.