Cardiac drug shows potential as treatment for alcohol use disorder

Drugs for heart disease and high blood pressure may also be effective in treating alcohol use disorders, according to new research by researchers at the National Institutes of Health and their colleagues. Converging evidence from cohort studies in humans suggests that the drug spironolactone may play a role in reducing alcohol consumption. It was led by scientists from the National Institute of Alcohol Abuse and Alcoholism Research (NIDA) and the National Institute of Alcohol Abuse and Alcoholism (NIAAA) and Yale University School of Medicine in New Haven, Connecticut. A report on the new findings can be found at molecular psychiatry.

“Combining the results of three species and different types of research studies and seeing the similarities in the data gives us confidence that we are working on something that may be of scientific and clinical importance. “These results support further research into spironolactone as a potential treatment for alcohol use disorders, a condition that affects millions of people in the United States,” said NIDA and NIAAA. said Lorenzo Leggio, MD, Ph.D., head of the clinical psychoneuroendocrinology and neuropsychopharmacology section of the joint laboratory and one of the lead authors. .

There are currently three drugs approved for alcohol use disorders in the United States, and they are effective and important adjuncts in the treatment of people with this disorder. Given the diverse biological processes that contribute to alcohol use disorders, new drugs are needed to offer a wider range of treatment options. Scientists are working to develop a wider menu of pharmaceutical treatments that can be tailored to individual needs.

Previous research has shown that mineralocorticoid receptors are present throughout the brain and other organs, help regulate water and electrolyte balance in the body, and may be involved in alcohol consumption and cravings. Preclinical studies suggest that higher mineralocorticoid receptor signaling contributes to increased alcohol consumption. It was intended to expand this line of research by testing the drug spironolactone. Spironolactone is used clinically as a diuretic to treat conditions such as heart problems and high blood pressure.

In experiments conducted in models of excessive alcohol consumption in mice and rats, NIAAA and NIDA researchers, led by NIDA co-lead author Leandro Vendruscolo, Pharm.D., Ph.D., reduced the dose of spironolactone. I found that alcohol consumption decreased when I increased it. both men and women. Female animals do not affect food and water intake without causing locomotion or coordination problems.

In a parallel study, part of this team’s collaboration, researchers led by co-lead author Amy C. Justice, MD, Ph.D. I checked. The U.S. Veterans Health System will evaluate potential changes in alcohol consumption following prescription for spironolactone’s current clinical indications (heart problems, hypertension, etc.). They found a significant association between spironolactone treatment and reduced self-reported alcohol consumption as measured by a screening tool, the Alcohol Use Disorders Identification Test-Consumption. , the greatest effect was seen in those who reported unsafe/heavy episodic drinking before starting spironolactone treatment.

“These are very encouraging results,” said NIAAA Director George F. Koob, Ph.D. “In summary, this study advocates the conduct of a randomized controlled study of spironolactone in people with alcohol use disorders to further evaluate the safety and potential efficacy of spironolactone in this population and to assess how spironolactone may Further research will be conducted to understand how alcohol consumption can be reduced. »

“People with substance use disorders, like other medical conditions, deserve to have a range of treatment options available. It’s an exciting step in the future,” said Nora, Volkow. , MD, Director of NIDA. “Additionally, we need to address the stigma and other barriers that keep many people with alcohol use disorders from accessing the treatments we already have.”

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