Heart medication could be used to treat alcohol use disorder

Heart medication could be used to treat alcohol use disorder

According to research from the National Institutes of Health, a medication used for heart problems and high blood pressure may be effective in treating alcohol use disorder.  

The study presents evidence taken from mice and rat models and a cohort study in humans, suggesting that the medication, spironolactone, could be used to reduce alcohol consumption. A report of the findings has been published in Molecular Psychiatry. 

“Combining findings across three species and different types of research studies, and then seeing similarities in those data gives us confidence that we are onto something potentially important scientifically and clinically. These findings support further study of spironolactone as a potential treatment for alcohol use disorder, a medical condition that affects millions of people in the US,” said Lorenzo Leggio, MD, PhD, chief at the laboratory on Clinical Psychoneuroendocrinology and Neuropsychopharmacology (CPN) and lead author on the study. 

A wider range of treatments is needed for alcohol use disorder

There are currently three approved medications for alcohol use disorder in the US; however, due to the diverse biological processes that contribute to alcohol use disorder, more medications are needed to provide a broader spectrum of treatment options.  

Previous research has found that mineralocorticoid receptors, which help regulate the body’s fluid and electrolyte balance, may play a role in alcohol use and craving. Preclinical research has suggested that higher mineralocorticoid receptors may lead to increased alcohol cravings.  

This study expanded on this research by testing spironolactone, a medication that can block mineralocorticoid receptors, as a treatment for alcohol consumption. Spironolactone is commonly used in clinical practice as a diuretic and to treat conditions like heart problems and high blood pressure. 

The research conducted experiments on mouse and rat models that found increasing doses of spironolactone decreased alcohol consumption in male and female animals. As well as this, using spironolactone did not cause any coordination or movement issues in the animals or affect their food and water intake.  

Spironolactone is effective for heavy drinkers

A parallel study was performed alongside this research by the Yale School of Medicine, which examined health records from a large sample of people from the US Veteran Affairs healthcare system. The researchers assessed potential changes in alcohol consumption after spironolactone was prescribed for its original purposes, e.g., heart problems and high blood pressure. They identified a significant association between spironolactone treatment and a reduction in self-reported alcohol consumption. The greatest effects were observed among those who had previously reported hazardous or heavy episodic drinking before starting spironolactone treatment. 

“These are very encouraging findings. Taken together, the present study argues for conducting randomised, controlled studies of spironolactone in people with alcohol use disorder to further assess its safety and potential efficacy in this population, as well as additional work to understand how spironolactone may reduce alcohol drinking,” said George F Koob, PhD, a co-author of the study.  

“Just like for any other medical condition, people with substance use disorders deserve to have a range of treatment options available to them, and this study is an exciting step in our effort to expand medications for people with alcohol use disorder,” added Nora Volkow, MD, director of the National Institute on Drug Abuse.  

“In addition, we must address the stigma and other barriers that prevent many people with alcohol use disorder from accessing the treatments we already have available.” 


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