Heart drug shows promise as new treatment for alcoholism, says NIH

A widely used heart drug is showing promise as a new treatment for alcoholism, according to the National Institutes of Health. Photo by kaicho20/Pixabay

Sept. 20 (UPI) — New research suggests that spironolactone, a widely used diuretic that treats heart problems and high blood pressure, may be an effective therapy for alcohol use disorder.

If further research builds evidence for this new approach, it could help treat a chronic disease that affects millions of people in the United States.

Only three medications are approved by the Food and Drug Administration to help people with this chronic condition: acamprosate, disulfiram, and naltrexone.

The researchers said that like any other medical condition, people with substance use disorders deserve to have a range of treatment options available to them. And even the currently available treatments, much less the dozens available to treat other diseases, are underutilized.

This makes it critical to find more medication options that can be tailored to individual needs and to better educate doctors about the use of currently available pharmaceuticals, Dr. Lorenzo Leggio, a physician and scientist at the National Institutes of Health and lead author of the new study, told UPI in a telephone interview Tuesday.

According to the new study, “People taking spironolactone drank less alcohol than those not treated, and heavier drinkers responded better to spironolactone…and the higher the dose, the stronger the ‘effect,” said Leggio, deputy scientific director and senior researcher at the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism.

Spironolactone “is not ready to be prescribed [for alcohol use disorder] — far from it. But it’s promising,” he said.

He added: “There is hope that if this line of research continues to show promise, eventually this [spironolactone] will be an additional tool” in treating alcohol use disorder.

Previous research has shown that mineralocorticoid receptors, which are found throughout the brain and other organs and help regulate the body’s fluid and electrolyte balance, could play a role in alcohol consumption and craving.

The new study, published online Monday night in the journal Molecular Psychiatry, extended that line of research by testing spironolactone, a drug that blocks mineralocorticoid receptors.

In experiments at the NIH on excessive alcohol consumption, researchers found in rats and mice that increasing doses of spironolactone reduced alcohol consumption. And it didn’t cause movement or coordination problems or affect her food or water intake.

“We now have these strong data from mice and rats that suggest safety,” Leggio said.

At the same time, researchers led by Dr. Amy C. Justice of the Yale School of Medicine analyzed the health records of a large sample of people in the US Veterans Affairs health care system.

They assessed potential changes in alcohol use among people who were prescribed spironolactone for their current clinical indications, such as heart problems and high blood pressure.

They found a strong association between spironolactone therapy and reductions in self-reported alcohol consumption by study participants.

The largest effects were seen among people who reported heavy or hazardous episodic drinking before starting spironolactone.

Leggio noted that these findings are consistent with a recent retrospective study that compared electronic health record data from 523 adults treated with spironolactone and 2,305 untreated adults at Kaiser Permanente Northern California.

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