Heart Medication Shows Potential as Treatment for Alcohol Use Disorder
Spironolactone, a medication for heart problems and high blood pressure, may also be effective for treating alcohol use disorder (AUD), according to a new National Institutes of Health study. The study presents converging evidence from experiments in rodents, as well as electronic health data from humans, suggesting that spironolactone may play a role in reducing alcohol drinking. The research, published in Molecular Psychiatry, was led by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and Yale School of Medicine in New Haven, Connecticut.
“Seeing similarities across species and research designs gives us confidence that we are onto something potentially important scientifically and clinically,” said Lorenzo Leggio, M.D., Ph.D., chief of the Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, a joint laboratory of NIDA and NIAAA, and one of the study’s senior authors.
Less than 10 percent of people with AUD receive any treatment, despite the availability of behavioral treatments and three safe and effective medications approved by the Food and Drug Administration. Given the diverse biological processes that contribute to AUD and the variability in the presentations of the disorder across individuals, research to identify new medications is needed to provide a broader spectrum of treatment options that can be tailored to individual needs.
Previous preclinical research suggests that signaling through a specific corticosteroid receptor (mineralocorticoid receptors), which can be blocked by spironolactone, might play a role in alcohol consumption and craving. In the present study, researchers showed, through experiments performed in mice and rats, that spironolactone decreases alcohol consumption. Moreover, in a complementary analysis of health records of a large sample of people from the U.S. Department of Veterans Affairs health care system, the researchers found that individuals who had been prescribed spironolactone (for reasons such as heart problems or high blood pressure) were more likely to self-report reductions in alcohol consumption.
“These results are encouraging,” said NIAAA Director George F. Koob, Ph.D., a co-author of the study. “This study provides scientific support for clinical studies to understand how the medication may reduce alcohol consumption and assess the safety and potential efficacy of spironolactone in humans with AUD.”
References
Farokhnia M, Rentsch CT, Chuong V, McGinn MA, Elvig SK, Douglass EA, Gonzalez LA, Sanfilippo JE, Marchette RCN, Tunstall BJ, Fiellin DA, Koob GF, Justice AC, Leggio L, Vendruscolo LF. Spironolactone as a potential new pharmacotherapy for alcohol use disorder: convergent evidence from rodent and human studies. Mol Psychiatry. 2022 Nov;27(11):4642–4652. Epub 2022 Sep 20. PubMed PMID: 36123420
NIAAA [Internet]. News Release: Heart medication shows potential as treatment for alcohol use disorder. 2022 Sept 20. [cited 2023 Jan 10]. Available from: https://www.niaaa.nih.gov/news-events/news-releases/heart-medication-shows-potential-treatment-alcohol-use-disorder
NIAAA [Internet]. Alcohol Treatment Navigator. What medications are available for treating AUD? [cited 2022 Oct 24] Available from: https://alcoholtreatment.niaaa.nih.gov/FAQs-searching-alcohol-treatment#topic-what-medications-treat-aud
In this Issue
Closing the Treatment Gap for Alcohol-Associated Liver Disease
Drinking too much—whether on a single occasion or over many years—can take a serious toll on an individual’s health. Clinicians across the health care spectrum can play important roles in preventing and treating the harmful effects of alcohol. This role is particularly important among providers who manage patients with liver diseases.
New Research Characterizes Alcohol Use Disorder Profiles To Predict Treatment Outcomes
Alcohol use disorder (AUD) is a heterogeneous disorder, meaning individuals with AUD differ in their clinical symptoms and in the biological and psychological factors that contribute to their disorder. A better understanding of individual differences in AUD could inform the development of tailored treatment approaches to increase treatment effectiveness. New research from the University of New Mexico, the University of Washington, and Syracuse University published in Psychology of Addictive Behaviors shows that assessing patients based on biological and psychological domains of addiction could
Researchers Gain New Insight Into the Development of Severe Alcohol-Associated Hepatitis
Alcohol misuse can lead to alcohol-associated hepatitis (AH), a form of liver disease with a high short-term mortality rate in severe cases. Currently, no medications have been approved by the U.S. Food and Drug Administration to treat AH, and liver transplantation is often required due to liver failure. A better understanding of how AH develops could help improve AH treatment and prevent progression to severe disease.
National Conference Focuses on Health Issues Affecting Women and Girls
In October, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Interagency Work Group on Drinking and Drug Use in Women and Girls (IWG) hosted the 2022 National Conference on Alcohol and Other Substance Use in Women and Girls: Advances in Prevention, Treatment, and Recovery. More than 400 attendees participated in the two-day virtual conference, which featured plenary lectures by NIAAA Director George F. Koob, Ph.D., National Institute on Drug Abuse Director Nora Volkow, M.D., and National Institute of Mental Health Director Joshua Gordon, M.D., Ph.D. Valerie A. Earnshaw
Alcohol-Related Deaths Continued To Increase in 2021
The figure above shows the number of alcohol-related deaths each month in 2019, 2020, and 2021. The annual total number of deaths increased 25% between 2019 and 2020 (from 78,927 to 99,017). The annual total number increased another 10% between 2020 and 2021 (from 99,017 to 108,891).