Heart medications show potential for use as a treatment for alcohol use disorder

new version

Tuesday 20 September 2022

A new study by researchers at the National Institutes of Health and their colleagues shows that a drug for heart problems and high blood pressure may also be effective in treating alcohol use disorder. The study provides converging evidence from experiments in mice and rats, as well as a cohort study in humans, that spironolactone may play a role in reducing alcohol drinking. The research was led by scientists at the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), both from the National Institutes of Health, and Yale University School of Medicine, New Haven, Connecticut. The new findings report has been published in Molecular Psychiatry.

“Combining the results across three different types and types of research studies, and then seeing the similarities in that data, gives us confidence that we are into something of potentially scientific and clinical interest. These findings support further study of spironolactone as a potential treatment for alcohol use disorder, and are A medical condition that affects millions of people in the United States.” NIDA and NIAAA laboratory, and one of the senior authors.

Currently there Three approved drugs for alcohol use disorder in the United StatesIt is an effective and important aid in the treatment of people with this condition. Given the diverse biological processes that contribute to alcohol use disorder, new drugs are needed to provide a broader range of treatment options. Scientists are working to develop a larger list of pharmaceutical treatments that can be tailored to individual needs.

Previous research has shown that mineralocorticoid receptors, which are located throughout the brain and other organs and help regulate fluid and electrolyte balance in the body, may play a role in alcohol abuse and craving. Preclinical research indicates that elevated mineralocorticoid receptor signaling contributes to increased alcohol consumption. The current study sought to extend this 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 using mouse and rat models of excessive drinking, NIAAA and NIDA researchers led by co-senior author Leandro Vendruscolo, MD, PhD, of NIDA found that increased doses of spironolactone reduced alcohol consumption in males and females. Female animals, without causing problems with movement or coordination, and without affecting their food or water intake.

In a parallel study that was part of this team’s collaborative effort, researchers led by co-lead author Amy C. Justice, MD, PhD, of Yale University School of Medicine, examined the health records of a large sample of people from the United States Veterans Affairs health care system. To evaluate potential changes in drinking alcohol after spironolactone is prescribed for its current clinical indications (eg, heart problems, high blood pressure). They found a significant association between spironolactone treatment and reduced self-reported alcohol consumption, as measured by Alcohol Consumption Test for Alcohol Use DisorderCheck tool. Of note, the largest effects were observed among those who reported serious alcohol use/heavy seizures before starting treatment with spironolactone.

NIAAA Director George F. Cobb, PhD, co-author of the study: “These are very encouraging results.” Taken together, the current study argues for randomized controlled studies of spironolactone in people with alcohol use disorder to assess its potential safety and efficacy in this population, as well as additional work to understand how spironolactone may reduce alcohol drinking.

“Just like any other medical condition, people with substance use disorders deserve to have the range of treatment options available to them, and this study is an exciting step in our efforts to expand the range of medications for people with alcohol use disorder,” said Nora Volkow. MD, director of the NIDA. “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.”

About the National Institute on Alcohol Abuse and Addiction (NIAAA): The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, is the primary US agency for conducting and supporting research on the causes, consequences, prevention, and treatment of alcohol use disorder. The NIAAA also publishes research findings to a general, professional, and academic audience. Additional information and publications for 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, the US Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. The Institute implements 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 country’s medical research agency, includes 27 institutes and centers and is part of the US Department of Health and Human Services. The National Institutes of Health is the primary federal agency that conducts and supports basic, clinical, and polymedical research, investigating causes, treatments, and treatments for both common and rare diseases. For more information about the National Institutes of Health and its programs, visit www.nih.gov.

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