Existing heart medications may help treat alcohol use disorders

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A study has found that an FDA-approved drug for cardiovascular disease, spironolactone, can be repurposed to treat alcohol use disorders. JW LTD/Getty Images
  • National Institutes of Health researchers studied a drug with existing FDA approval to see if it would work for other purposes.
  • Spironolactone is prescribed to treat heart disease. Because the drug is a mineralocorticoid receptor antagonist, the researchers were interested to see if it would provide benefits in the treatment of alcohol use disorders.
  • At the end of the study, the group learned that the drug showed promise in reducing alcohol consumption.

Sometimes researchers find new uses for existing drugs, which is helpful because they assume they already know about potential side effects. A National Institutes of Health (NIH) study indicates that the heart medication spironolactone may be effective for patients with alcohol use disorders.

Although more research is needed on the use of spironolactone for this purpose, researchers have conducted studies in rats, mice, and humans and found that the drug may have benefits. The findings were published in Molecular psychiatry.

According to National Institute on Alcohol Abuse and Alcoholism (NIAAA)a division of the National Institutes of Health (NIH), alcohol use disorder “is a medical condition characterized by an impaired ability to stop or control alcohol consumption despite adverse social, occupational, or health consequences” .

In the United States, 17 million adults aged 18 or older suffer from alcohol use disorders, according to the Agency for Health Care Research and Quality (AHRQ), part of the Department of Health and Social Services.

Additionally, the AHRQ indicates that men are more likely to develop the disease than women. They predict that 17% of men and 8% of women will develop an alcohol use disorder at some point.

Some people are at higher risk of developing an alcohol use disorder, including people who started drinking before they were 15, those who use alcohol, and those with a family history of drinking. alcohol abuse or mental health issues.

Some of the features of the disorder include:

  • Being unable to stop or cut down on alcohol consumption
  • Getting into situations that can have harmful effects because of alcohol
  • Having withdrawal symptoms after the alcohol wears off
  • binge drinking

There are a number of treatments for people with alcohol use disorders, including therapy and medication. Three FDA-approved medications for alcohol use disorders are naltrexone, disulfiram, and acamprosate.

One of the main reasons researchers have studied spironolactone is that the drug is found in the mineralocorticoid receptor (MR) class of antagonist drugs.

“Aldosterone, a steroid hormone, and its associated mineralocorticoid receptor regulate fluid and electrolyte homeostasis,” according to the study authors. Based on preliminary research suggesting that aldosterone and MR may help with alcohol seeking and drinking, the authors turned to spironolactone as it may possibly reduce this desire.

Researchers conducted three studies that looked at the use of spironolactone to treat alcohol abuse. They conducted studies on rats, mice and humans.

In the rat study, there were two categories of rats: alcohol-dependent rats and non-addicted rats. After injecting spironolactone into both categories of rats, the rats had to press a lever to receive alcohol.

In the study with mice, the researchers tested spironolactone on mice that were allowed to binge on sugary and unsweetened alcoholic solutions. The scientists injected the mice with spironolactone before giving them access to the solutions.

In the human cohort study, researchers collected data from the U.S. Department of Veterans Affairs on people who were prescribed spironolactone for one of its approved indications for at least 60 days and who reported consuming alcohol. The researchers matched each of these people with up to five people not exposed to the drug.

Rat and mouse studies have shown a decrease in alcohol consumption with spironolactone injections. Additionally, the authors noted that spironolactone did not impair coordination or movement, or affect their food and water intake.

In the human study, researchers observed a decrease in their self-reported alcohol consumption in the group that took spironolactone. Spironolactone had the greatest effect on people who reported heavy drinking as binge drinking.

“These are very encouraging results. Overall, the present study argues for conducting randomized, controlled studies 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 can reduce alcohol consumption.

– George F. Koob, Ph.D., study co-author

Dr. Koob is the director of the National Institute on Alcohol Abuse and Alcoholism.

Study co-lead author Dr Lorenzo Leggio spoke with Medical News Today on the future of research on alcohol use disorders and spironolactone. Dr Leggio said they needed “placebo-controlled studies to assess the potential safety and efficacy of spironolactone in people with alcohol use disorder (AUD).”

Dr. Leggio is the Principal Investigator of the Clinical Section of Psychoneuroendocrinology and Neuropsychopharmacology (CPN), a joint laboratory of NIDA and NIAAA.

Suppose scientists continue their research on spironolactone and eventually submit it for regulatory approval to treat alcohol use disorders. If so, it could become the fourth FDA-approved drug to be indicated for this disorder.

This study highlights the importance of continuing research on existing drugs.

“Thanks to advances in the field of biomedical addiction research, we are improving our understanding of the mechanisms of development of AUD in some people; we can therefore use this knowledge to identify new targets and develop new treatments for AUD.

– Dr. Leggio

According to Centers for Disease Control and Prevention (CDC), more than 140,000 people die each year from excessive alcohol consumption. With that in mind, he highlights why it’s important to focus on repurposing existing drugs to treat the disorder and developing new ones.

“Given that this is an old drug that has been used for decades in clinical practice for other indications, the reuse of spironolactone allows us to move quickly to the next steps,” commented Dr. Leggio.

Dr. Orman Trent Hall, a board-certified addictologist and addiction researcher at Ohio State University Wexner Medical Center, also spoke with DTM about the study.

“Alcohol consumption is one of the leading causes of death and disability worldwide,” Dr Hall said. “When people become addicted, they find themselves drinking in a way that feels out of control and find it hard to stop even after realizing that alcohol is hurting them.”

“The discovery of new drugs for AUD offers hope for a future where fewer people suffer from the worst consequences of this disorder,” commented Dr Hall.

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