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A joint heart and blood pressure drug could be used as a second measure to treat alcohol use disorders, new government-led research suggests this week. The study found evidence in both rodents and humans that the drug spironolactone can reduce alcohol cravings and consumption.
spironolactone was in the medicine cabinet for decades and was first discovered in the late 1950s. It is a type of steroid used primarily for its diuretic effects, meaning that it induces the loss of water and sodium through increased urine production. It has long been used to reduce fluid buildup caused by conditions like heart failure and kidney disease, reducing the risk of later serious complications; It is also used in combination with other medications to lower high blood pressure.
Over the years, spironolactone has been found to be useful for other health issues beyond these indications. Because it can block the production of androgen hormones, for example, which are linked to excess oil production sometimes used to treat acne in women (in men it causes low testosterone levels, which are not worth the side effects). And some research has begun to show that the receptors inhibited by spironolactone may also play a role in promoting alcohol consumption. If that’s the case, the drug could help people suffering from alcohol use disorder — a chronic condition with few treatments.
To better understand the drug’s potential, researchers at the National Institutes of Health decided to study its effects on mice and rats tricked into getting drunk or addicted to alcohol. They found that increasing spironolactone doses resulted in correspondingly lower alcohol consumption in both species of rodents, males and females, with no potential side effects such as decreased appetite for food and water.
A second part of the research analyzed the medical records of patients treated by veterans Affairs, the country’s largest integrated healthcare system. Compared to similarly matched controls not taking the drug, VA patients taking spironolactone for other conditions reported greater reductions in alcohol consumption afterwards. And this reduction was greatest among people who reported the highest alcohol consumption before taking the drug and among people taking the highest doses of spironolactone.
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these insights, released Tuesday in the journal Molecular Psychiatry, is not the definitive evidence needed to approve spironolactone as a new treatment for alcohol use disorders. But the divergent lines of evidence suggest it’s now worth investing the time and resources to find out for sure, say the authors.
“These are very encouraging results,” said study author George Koob, director of the National Institute on Alcohol Abuse and Alcoholism expression from the NIH. “Overall, the present study advocates conducting randomized, controlled trials of spironolactone in people with alcohol use disorder to further evaluate its safety and potential efficacy in this population, and additional work to understand how spironolactone may reduce alcohol consumption.”
There are three approved drugs for alcohol use disorder. Only two of these drugs, naltrexone and acamprosate, are considered effective front-line treatments (the third drug, disulfiram, causes Symptoms such as nausea when trying to drink and is usually only recommended as a last resort). So, More treatments are certainly needed for this difficult-to-treat condition. It is estimated that 14.5 million Americans struggle with an alcohol use disorder, defined as a chronic physical and emotional dependence on alcohol that harms themselves and others. However, less than 10% of those affected have received treatment in the past year, according to the National Institute on Alcohol Abuse and Alcoholism.
