A medicine for the flaky skin condition psoriasis could be used to treat alcohol dependence. People with alcohol use disorders (AUD) who took the drug significantly cut their alcohol intake, a small trial has found.
AUD are generally treated using various forms of therapy and group counselling sessions such as those in Alcoholics Anonymous’s Twelve Steps programme. However, people often relapse.
Recent studies have shown that people are more likely to drink too much if they have genetic variants causing higher levels of an enzyme called phosphodiesterase 4 (PDE4).
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at Oregon Health & Science University and her colleagues wondered if a psoriasis treatment called apremilast, which blocks this enzyme, could help reduce alcohol cravings.
First, the team tested the drug in mice that had been bred to like and overconsume alcohol, and found that it lowered how much the rodents drank.
Apremilast also had this effect when administered directly into part of the animals’ brains called the nucleus accumbens. In people, this brain region is thought to play a role in many kinds of addictions.
Previous research has shown that a few people with severe alcoholism have been able to stop drinking after electrodes were implanted into their brains to electrically stimulate this area.
Next, Ozburn’s team carried out a trial of apremilast involving 51 people with AUD. They had been drinking heavily for about 12 years and weren’t seeking treatment. People took a tablet twice a day of either the drug or a placebo.
After 11 days, those who got the drug cut their daily drinking from an average of five standard alcoholic drinks – each of which contains around 14 grams of alcohol – to just over two. People in the placebo group reduced their intake by about half a drink.
This was a large effect, says Ozburn. “We see a lot of harm reduction, even though we don’t see complete abstinence.”
Nausea is a known side effect with apremilast in people taking it for psoriasis. In the trial, more people reported nausea in the apremilast group than in the placebo group, but this was generally mild and didn’t cause anyone to stop taking the drug.
Several other drugs that have different mechanisms are currently available for people trying to quit alcohol, but it is unclear how well they work.
“PDE4 inhibitors could potentially offer a novel therapeutic approach to the treatment of people with alcohol dependence,” says at King’s College London. “Further research involving larger trials will be needed to explore more closely the clinical benefits and risks.”
“We have a relatively small treatment arsenal at the moment and any expansion would be welcome,” says , also at King’s College London.
Reference: bioRxiv, DOI:
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