Spironolactone, a heart and blood pressure medicine, may help treat alcohol use disorder. In a new study, people taking it for heart problems or high blood pressure drank significantly less. The drop was largest in the heaviest drinkers. Few medicines treat alcohol use disorder, so this one is worth studying further.
Summary: Alcohol use disorder is a major problem in the US and causes many deaths. Yet very few medicines treat it. Now a new study suggests a common high blood pressure medicine may help cut alcohol cravings. People who used it for heart problems or high blood pressure reported drinking significantly less. The drug worked especially well for people who drank the most.
Heavy drinking is a major problem in the US. It causes 380 deaths a day, or 140,000 deaths each year. Yes, these numbers are huge. Also, many of those who die due to excessive alcohol use are fairly young adults. Heavy drinking also harms millions of lives.
Most people can drink responsibly. But alcohol use disorder is a major problem in the US and around the world. Alcohol is easy and legal to get, and more than 80% of adults drink now and then. So it is no surprise that many drink too much.
Alcohol use disorder is an age-old problem, yet it has gotten fairly little attention. Many people with it need medical treatment. Sadly, very few drugs work even moderately well. Doctors may use medicines that change how the body breaks down alcohol, making drinking unpleasant. Or they may use drugs that cut alcohol cravings. But most medicines for alcohol use disorder work only moderately well. Some have unpleasant side effects too. So researchers are looking for safer, better remedies. One may be a popular heart medicine.
This popular heart medicine is called spironolactone. It is a water pill used for high blood pressure. It has been in use for a long time, so it has a proven safety record. Now animal studies and clinical trials suggest it may work well for alcohol use disorder, because it cuts alcohol cravings. The latest study was published in Molecular Psychiatry.
Spironolactone is an interesting drug in many ways. Studies show it has many other health effects. That is why doctors are also testing it for other brain disorders. It is even used for hair loss and many other health problems.
Researchers found that mice given spironolactone had less urge to drink alcohol. Studies also show that when people take spironolactone for high blood pressure, they report drinking less because the urge is weaker.
Studies suggest this may come from its effect on mineralocorticoid receptors. These receptors sit throughout the brain and other organs. They play a key role in the body’s fluid and salt balance. Too many of these receptors in the brain seem tied to alcohol use disorder. So blocking them seems to cut alcohol urges, or cravings, in people with alcohol use disorder.
In the study, researchers looked at US Veterans Affairs health system data. People taking spironolactone reported drinking less. Interestingly, those who drank the most were more likely to cut back after taking spironolactone.
Researchers say these findings are very encouraging. Spironolactone is known to be a nonselective mineralocorticoid receptor (MR) blocker. It seems to change alcohol-seeking behavior by acting on these receptors in the brain.
Researchers also found that spironolactone cut alcohol intake on its own. The higher the dose, the more it cut alcohol self-administration.
Researchers say strong evidence from rodent studies and clinical trials shows it works. So there is an urgent need to test this drug further for treating alcohol use disorder. The drug is already approved for other conditions, so it can be quickly brought in for alcohol use disorder. Reusing a drug already in medical use is much easier than building a new treatment.
Frequently asked questions
Can spironolactone reduce alcohol cravings?
Yes. Spironolactone, a water pill used for high blood pressure, cut the urge to drink in mice. People who take it for heart problems or high blood pressure report drinking less. A study of US Veterans Affairs health data was published in Molecular Psychiatry. Patients on spironolactone reported drinking less, and the heaviest drinkers were the most likely to cut back.
How does spironolactone reduce the urge to drink?
Spironolactone blocks mineralocorticoid receptors. These receptors sit throughout the brain and other organs and help control fluid and salt balance. Overactive receptors in the brain seem tied to alcohol use disorder. So blocking them lowers alcohol urges and cravings. In studies, the drug also cut alcohol self-administration, more so at higher doses.
What is spironolactone used for?
Spironolactone is a water pill used to manage high blood pressure and heart problems. It has been in use for a long time and has a proven safety record. It is also used for hair loss and other health problems. Doctors are testing it for brain disorders, including alcohol use disorder.
Why is a heart medicine being studied for alcohol use disorder?
Very few medicines work well for alcohol use disorder, and some in use have unpleasant side effects. Spironolactone is already approved for other conditions and has a long safety record. So it can be brought in for alcohol use disorder far more easily than a brand-new drug. Reusing a medicine already in medical use is much easier than building a new one.
Related reading
Workouts and Alcohol Consumption · Psilocybin for Alcohol Use Disorder · Chronic Pain from Alcohol Withdrawal May Be Permanent
Sources
- Farokhnia M, Rentsch CT, Chuong V, et al. Spironolactone as a potential new pharmacotherapy for alcohol use disorder: convergent evidence from rodent and human studies. Mol Psychiatry. 2022;27(11):4642-4652. PMID 36123420 · DOI 10.1038/s41380-022-01736-y.