Promising Advance in the Fight Against Alcoholism

By Daniel K. Brantley
Monday, January 25, 2021

Researchers explore a new use for prazosin.

Alcohol misuse affects more than 14 million American adults and contributes to a range of negative medical and social effects. Overcoming alcohol use disorder (AUD) has its own set of complications. Withdrawal symptoms can be severe and disturbing, causing sleeping difficulty, mental health issues such as mood swings and anxiety, and ongoing desire for alcohol.

Until recently, these negative consequences were considered an unavoidable aspect of overcoming AUD. According to Rajita Sinha, PhD, Professor of Neuroscience at Yale School of Medicine and Director of the Yale Stress Center, clinicians were helpless to take action.

“There has been no treatment readily available for people who experience severe withdrawal symptoms,” Sinha told YaleNews. “[T]hese are the people at highest risk of relapse and are most likely to end up in hospital emergency rooms.”

Research recently published in The American Journal of Psychiatry may change that. This study found a new potential treatment for those dealing with alcohol withdrawal symptoms: prazosin.

Rebranding Blood Pressure Medication

For years, prazosin has been considered an effective therapy for treating high blood pressure. It has also been studied for its potential to treat post-traumatic stress disorder. In a double-blind, randomized, controlled proof-of-concept trial, Yale University researchers found it may help manage AUD withdrawal symptoms.

During the 12-week study, researchers monitored 100 individuals. Each participant had been diagnosed with AUD, suffered various levels of withdrawal, and was beginning outpatient rehabilitation for alcohol recovery. One group of participants were prescribed a daily placebo, and another group received 16 milligrams of prazosin, which was given on a two-week titration.

At the close of the study, researchers found the medication had little to no effect on those with mild withdrawal symptoms. However, prazosin had a significant effect on those who suffered extreme withdrawal symptoms. Among this subset of participants, those who took prazosin indulged in significantly fewer days of heavy drinking during the study. They also drank on fewer days overall.

Looking Forward to Reduced Withdrawal

The early days of overcoming AUD are often filled with challenges. Prazosin may help patients get through these days, as the medication seems to diminish alcohol cravings and withdrawal symptoms.

While the initial evidence is promising, prazosin’s efficacy as a means to overcome withdrawal symptoms is not yet definitive. Further research is needed before it can be recommended as an appropriate care mechanism in the clinical setting.

One issue Sinha points out is the requirement that the medication be taken three times each day. A single pill would be much more manageable for patients. Perhaps such an option will be developed in the future, offering even greater hope to those recovering from AUD.