Epironolactone may help treat alcohol use disorder: Study

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Image for article titled A common heart drug can help people struggling with alcohol use disorder

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New government-led research this week suggests a common heart and blood pressure drug could see a second act as a treatment for alcohol use disorder. The study found evidence in both rodents and humans that the medication spironolactone can reduce people’s desire for and consumption of alcohol.

spironolactone it has been in the medicine cabinet for decades, after being discovered in the late 1950s. It is a type of steroid that is used mainly for its diuretic effect, that is, it induces the loss of water and sodium by increasing the production of urine. It has long been used to reduce fluid build-up caused by conditions such as heart failure and kidney disease, reducing the risk of serious complications later; it is also used in combination with other drugs to lower high blood pressure.

Over the years, it has become clear that epironolactone is useful for other health problems beyond these indications. Because it can block the production of androgen hormones related to excess oil production, for example, it is sometimes used to treat acne in women (in men, it causes low testosterone levels that are not worth the side effects). And some research has begun to show that the receptors inhibited by epironolactone may also play a role in driving people’s alcohol consumption. If that’s the case, then the drug could help people with alcohol use disorder, a chronic disease 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 that were made intoxicated or dependent on alcohol. They found that increasing doses of spironolactone led to correspondingly lower levels of alcohol consumption among both types of rodents, male and female, and without possible adverse effects such as a reduction in appetite for food and water .

A second part of the investigation they analyzed the medical records of patients treated through Veterans Affairs, the largest integrated healthcare system in the country. Compared with similar control patients not taking the drug, VA patients on spironolactone for other conditions reported less alcohol consumption afterward. And this reduction was greatest in people who reported the highest levels of alcohol consumption before taking the drug, as well as in people who took the highest doses of spironolactone.

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These findings, published Tuesday in the journal Molecular Psychiatry, they are not the kind of definitive proof needed to approve epironolactone as a new treatment for alcohol use disorder. But different lines of evidence show that it’s now worth spending the time and resources to find out for sure, the authors say.

“These are very encouraging findings,” study author George Koob, director of the National Institute on Alcohol Abuse and Alcoholism, said in a statement from the NIH. “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.”

There are three of them approved medications for alcohol use disorder. Only two of these drugs, naltrexone and acamprosate, are considered effective first-line treatments (the third drug, disulfiram, causes symptoms such as nausea when a person tries to drink and is usually only recommended as a last resort). So, More treatments are certainly needed for this difficult-to-manage condition. Is beloved that 14.5 million Americans struggle with alcohol use disorder, defined as a chronic physical and emotional dependence on alcohol that harms themselves and others. But less than 10% of sufferers have received any treatment in the past year, according to the National Institute on Alcohol Abuse and Alcoholism.

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