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Heart drug shows promise as new alcoholism treatment, NIH says

A widely used heart medication shows promise as a new treatment for alcoholism, the National Institutes of Health says. Photo by kaicho20/Pixabay
A widely used heart medication shows promise as a new treatment for alcoholism, the National Institutes of Health says. Photo by kaicho20/Pixabay

Sept. 20 (UPI) -- Spironolactone, a widely used diuretic that treats heart problems and high blood pressure, may be an effective therapy for alcohol use disorder, new research suggests.

If further research builds evidence for this new approach, it would help treat a chronic illness that affects millions of people in the United States.

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Only three drugs are approved by the Food and Drug Administration to help people with this chronic disease: acamprosate, disulfiram and naltrexone.

Researchers said that, like any other medical conditions, people with substance use disorders deserve to have a range of treatment options available to them. And even the currently available treatments -- far fewer than the dozens available to treat other illnesses -- are underutilized.

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This makes it critical to find more medication options that may be tailored to individual needs, and to better educate clinicians on the use of currently available pharmaceuticals, Dr. Lorenzo Leggio, a physician-scientist at the National Institutes of Health and a senior author of the new study, told UPI in a phone interview Tuesday.

According to the new study, "People taking spironolactone drank less alcohol than those untreated -- and heavier drinkers responded best to spironolactone ... and the higher the dose, the stronger the effect," said Leggio, deputy scientific director and senior investigator at the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism.

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Spironolactone "isn't ready to be prescribed [for alcohol use disorder] -- far from that. But it's promising," he said.

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He added: "There is a hope that if this line of research will continue to show promise, eventually this [spironolactone] will be one additional tool" to treat alcohol use disorder.

Previous research has shown that mineralocorticoid receptors, which are found throughout the brain and other organs and help regulate the body's fluid and electrolyte balance, might play a role in alcohol use and craving.

The new study, published online Monday night in the journal Molecular Psychiatry, expanded on this line of research by testing spironolactone, a medication that blocks mineralocorticoid receptors.

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In experiments at NIH looking at excessive alcohol drinking, the researchers found in rats and mice that increasing doses of spironolactone decreased alcohol consumption. And it didn't cause movement or coordination problems or affect their food or water intake.

"We now have this robust data from mice and rats suggesting safety," Leggio said.

In parallel work, researchers led by Dr. Amy C. Justice of the Yale School of Medicine analyzed health records of a large sample of people from the U.S. Veterans Affairs healthcare system.

They assessed potential changes in alcohol drinking among people who were prescribed spironolactone for its current clinical indications, including heart problems and high blood pressure.

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They found a strong association between spironolactone therapy and reduced alcohol consumption, which was self-reported by study participants.

The largest effects were observed among people reporting hazardous or heavy episodic alcohol consumption before they began taking spironolactone.

Leggio noted these findings are consistent with a recent retrospective study that compared electronic health record data from 523 spironolactone-treated adults and 2,305 untreated adults with Kaiser Permanente Northern California.

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