Heart Medication Shows Potential for Treating Alcohol Use Disorder

A new NIH study has found that a medication for heart problems and high blood pressure may also be effective for treating alcohol use disorder (AUD).

The study presents converging evidence from experiments in mice and rats, as well as a cohort study in humans, suggesting the medication, spironolactone, may play a role in reducing alcohol drinking. The research was led by scientists at NIDA and NIAAA in conjunction with Yale School of Medicine. A report of the new findings is published in Molecular Psychiatry.

“Combining findings across three species and different types of research studies, and then seeing similarities in those data, gives us confidence that we are onto something potentially important scientifically and clinically,” said Dr. Lorenzo Leggio, chief of the clinical psychoneuroendocrinology and neuropsychopharmacology section, a joint laboratory of NIDA and NIAAA.

Currently there are three medications approved for AUD in the U.S. and they are effective treatments. Given the diverse biological processes that contribute to AUD, new medications are needed to provide a broader spectrum of treatment options. 

Previous research has shown that mineralocorticoid receptors, located throughout the brain and other organs and that help regulate fluid and electrolyte balance in the body, might play a role in alcohol use and craving. Preclinical research suggests that higher mineralocorticoid receptor signaling contributes to increased alcohol consumption. 

The current study sought to expand this line of research. In experiments conducted in mouse and rat models of excessive alcohol drinking, NIAAA and NIDA researchers found that increasing doses of spironolactone decreased alcohol consumption in male and 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 collaboration, researchers examined health records of a large sample of people from the U.S. Veterans Affairs health care system to assess potential changes in alcohol drinking after spironolactone was prescribed for its current clinical indications. They found a significant association between spironolactone treatment and reduction in self-reported alcohol consumption, as measured by a screening tool. 

Of note, the largest effects were observed among those who reported hazardous, heavy episodic alcohol consumption before starting spironolactone treatment.

NIDA director Dr. Nora Volkow said, “Just like for 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 effort to expand medications for people with alcohol use disorder.”