Cardiac medication shows potential as a treatment for alcohol use disorder

News release

Tuesday, September 20, 2022

A drug for heart problems and high blood pressure may also be effective in treating alcohol use disorder, according to a new study by researchers at the National Institutes of Health and colleagues. The study presents converging evidence from experiments with mice and rats, as well as a cohort study in humans, suggesting that the medication, spironolactone, may play a role in reducing alcohol consumption. The research was led by scientists from the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), both parts of the NIH, and the Yale School of Medicine, New Haven, Conn. A report of the new findings is published in Molecular Psychiatry.

“Combining findings from three species and different types of research studies, and then seeing similarities in these data, gives us confidence that we are onto something potentially scientifically and clinically important. These findings support further study of the spironolactone as a potential treatment for alcohol use disorder, a medical condition that affects millions of people in the United States,” said Lorenzo Leggio, MD, Ph.D., chief of the Section of Psychoneuroendocrinology and Clinical Neuropsychopharmacology, a whole set laboratory at NIDA and NIAAA, and one of the senior authors.

There are currently three medications approved for alcohol use disorder in the United States, and they are effective and important aids in the treatment of people with this condition. Given the diverse biological processes that contribute to alcohol use disorder, new medications are needed to provide a broader spectrum of treatment options. Scientists are working to develop a wider menu of pharmaceutical treatments that can be tailored to individual needs.

Previous research has shown that mineralocorticoid receptors, which are found throughout the brain and other organs and help regulate fluid and electrolyte balance in the body, could play a role in alcohol consumption and craving. Preclinical research suggests that higher mineralocorticoid receptor signaling contributes to increased alcohol consumption. The current study sought to extend this line of research by testing spironolactone, a drug with multiple actions, including blocking mineralocorticoid receptors. Spironolactone is used in clinical practice as a diuretic and to treat conditions such as heart problems and high blood pressure.

In experiments conducted in mouse and rat models of excessive alcohol consumption, NIAAA and NIDA researchers led by co-senior author Leandro Vendruscolo, Pharm.D., Ph.D., of NIDA found that increasing doses of spironolactone reduced alcohol consumption in men and men. female animals, without causing movement or coordination problems, and without affecting their food or water intake.

In a parallel study that was part of this team’s collaborative efforts, researchers led by co-senior author Amy C. Justice, MD, Ph.D., of the Yale School of Medicine, examined the records of health of a large sample of people from the Yale School of Medicine. The US Veterans Affairs health system to assess potential changes in alcohol consumption after spironolactone is prescribed for its current clinical indications (eg, heart problems, high blood pressure). They found a significant association between spironolactone treatment and reduction in self-reported alcohol use, as measured by the Alcohol Use Disorders Identification Test, a screening tool. Of note, the largest effects were observed among those who reported episodic hazardous/heavy alcohol use prior to initiation of spironolactone treatment.

“These are very encouraging findings,” said NIAAA Director George F. Koob, Ph.D., co-author of the study. “Altogether, the present study argues for randomized controlled trials of spironolactone in people with alcohol use disorders to further evaluate its safety and potential efficacy in this population, as well as further work to understand how spironolactone may reduce alcohol consumption.”

“As with any other medical condition, people with substance use disorders deserve to have a range of treatment options available, and this study is an exciting step in our effort to expand medications for people with use disorders of alcohol,” said Nora Volkow. , MD, director of NIDA. “Also, we need to address the stigma and other barriers that prevent many people with alcohol use disorder from accessing the treatments we already have available.”

About the National Institute on Alcohol Abuse and Alcoholism (NIAAA): The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, is the lead agency in the United States for conducting and supporting research on the causes, consequences, prevention, and treatment of substance use disorders of alcohol NIAAA also disseminates research findings to general, professional, and academic audiences. Additional information and publications on alcohol research are available at: https://www.niaaa.nih.gov.

About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, US Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute conducts a wide variety of programs to inform policy, improve practice, and advance the science of addiction. For more information about NIDA and its programs, visit https://www.nida.nih.gov.

About the National Institutes of Health (NIH):NIH, the nation’s medical research agency, includes 27 institutes and centers and is a component of the US Department of Health and Human Services. NIH is the lead federal agency that conducts and supports basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH… Turning discovery into health®

###

Leave a Reply