Medications can be surprisingly versatile and it’s not unusual for doctors to prescribe a treatment that is “off label.” This means the medication wasn’t originally developed for your condition, but has been found to help.
Spironolactone, a commonly used diuretic designed to treat high blood pressure and other heart issues may well fall into this category. It appears to help people reduce their consumption of alcohol.
Recent studies on rodents, as well as humans, show spironolactone may also be effective at reducing the craving and consumption of alcohol. That’s a big deal because according to the National Institute on Alcohol Abuse and Alcoholism, as many as 15 million people are dealing with the debilitating effects of alcohol.
How does spironolactone come into play? Previous studies showed that something called “mineralocorticoid receptors” are involved in the regulation of fluid and electrolyte balance. These receptors also contribute to alcohol use disorder. Specifically, when mineralocorticoid receptors are high, they send a signal which appears to contribute to increasing the craving and consumption of alcohol. Spironolactone blocks these particular receptors.Veterans' health records showed a significant association between spironolactone prescribed for heart issues and high blood pressure and reductions of self-reported alcohol consumption.
Experiments using mice and rats showed that by upping the dosage of spironolactone, the animal’s alcohol craving and consumption decreased. But that’s not all.
In a parallel collaborative study of patients in the U.S. Veterans Affairs healthcare system, led by Amy C. Justice of the Yale School of Medicine, researchers analyzed health records of a large sample of Veterans and found a significant association between spironolactone prescribed for its current clinical use (heart issues and high blood pressure) and the reduction of self-reported alcohol consumption. This was especially significant among heavy users.
Presently there are only three medications approved for the use of this disorder, so these findings may lead to a wider spectrum of treatment options that are not only effective — but can be better tailored to an individual’s need.
“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,” co-senior author, Lorenzo Leggio, chief of a National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism joint laboratory, said in a press statement. “These findings support further study of spironolactone as a potential treatment for alcohol use disorder.”
How do you know if your drinking is a problem? These three issues may indicate that you are dealing with alcohol use disorder:
- You feel as if you must drink.
- You can’t control how much your drink.
- You feel bad emotionally and/or physically if you don’t drink.
If you answered yes to any, or all of these statements, speak with your healthcare provider about your concerns.
Spironolactone “isn’t ready to be prescribed [to treat alcoholism],” Leggio cautions. “…But it’s promising.” And there’s good reason to be hopeful. “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.
The study is published in Molecular Psychiatry.