Heart medication spironolactone may also treat alcohol use disorder

By The Science Advisory Board staff writers

September 21, 2022 -- Spironolactone, a diuretic medication used for heart problems and high blood pressure, may also effectively treat alcohol use disorder by reducing consumption. A new study presenting converging evidence from mouse and rat experiments, as well as a human cohort, was published September 20 in Molecular Psychiatry.

Previous research showed that mineralocorticoid receptors, which are located throughout the body and help regulate fluid and electrolyte balance, play a role in alcohol use. Higher mineralocorticoid receptor signaling seems to contribute to increased alcohol consumption and craving.

Spironolactone blocks these mineralocorticoid receptors. In mouse and rat experiments, researchers found that increased doses of spironolactone decreased the animals' alcohol consumption.

In a parallel collaborative study of patients in the U.S. Veterans Affairs healthcare system, researchers found a significant association between spironolactone prescribed for its current clinical use and reduction in self-reported alcohol consumption -- particularly among heavy consumers.

Given the many factors that contribute to alcohol use disorder, new medications beyond the three currently approved in the U.S. may provide a broader spectrum of treatment options better tailored to individual needs.

"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. These findings support further study of spironolactone as a potential treatment for alcohol use disorder, a medical condition that affects millions," said co-senior author Lorenzo Leggio, PhD, chief of a National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism joint laboratory.

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