Heart medications show potential as treatment for alcohol use disorder

Press release

Tuesday, September 20, 2022

A drug for heart problems and high blood pressure may also be effective in treating alcohol use disorders, according to a new study by National Institutes of Health researchers and their colleagues. The study presents converging evidence from experiments in mice and rats, as well as a cohort study in humans, suggesting that the drug, 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 of the NIH, and the Yale School of Medicine, New Haven, Connecticut. A report on the new findings is published in Molecular psychiatry.

“Combining results from three species and different types of research studies, and then seeing similarities in that data, gives us confidence that we’re onto something that is potentially scientifically and clinically important. These results support further study. of 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., Clinical Section Chief of Psychoneuroendocrinology and Neuropsychopharmacology, a laboratory association of NIDA and NIAAA, and one of the principal authors.

There are currently three drugs approved for alcohol use disorder in the United States, and they are an effective and important aid in the treatment of people with this disease. Given the diverse biological processes that contribute to alcohol use disorders, new drugs are needed to provide a wider range of treatment options. Scientists are working to develop a broader menu of pharmaceutical treatments that could 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 consumption and craving. . Preclinical research suggests that higher mineralocorticoid receptor signaling contributes to increased alcohol consumption. The current study aimed to expand 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 on models of excessive alcohol consumption in mice and rats, NIAAA and NIDA researchers led by co-lead author Leandro Vendruscolo, Pharm.D., Ph.D., of NIDA have found that increasing doses of spironolactone decreased alcohol consumption in both men and women. 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-lead author Amy C. Justice, MD, Ph.D., of the Yale School of Medicine, reviewed the medical records of a large sample of people from the United States Veterans Health System to assess potential changes in alcohol consumption after prescription of spironolactone 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 consumption, as measured by the Alcohol Use Disorders Identification Test-Consumption, a screening tool. Of note, the greatest effects were seen in those who reported hazardous/heavy episodic drinking before starting spironolactone treatment.

“These are very encouraging results,” said NIAAA Director George F. Koob, Ph.D., study co-author. “Taken together, this study argues for conducting randomized, controlled studies of spironolactone in people with alcohol use disorders to further assess its safety and potential efficacy in this population, as well as further work to understand how spironolactone can reduce alcohol consumption.”

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

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 principal US agency responsible for conducting and supporting research into the causes, consequences, prevention, and treatment of alcohol use disorders. ‘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 much of the world’s research on the health aspects of drug use and addiction. The Institute runs a wide variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit https://www.nida.nih.gov.

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

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