• Posted April 18, 2024

Two-Drug Combo Curbs Drinking for People Battling Severe Alcoholism

A combo of an allergy drug and a blood pressure med appears to lower daily drinking in folks battling severe alcoholism, French researchers report.

The two generic drugs are the antihistamine cyproheptadine and prazosin, which treats high blood pressure and urinary urgency, noted a team led by Henri-Jean Aubin, of the Université Paris-Saclay in Villejuif.

Aubin's group thought the drug duo might work against alcohol use disorder because cyproheptadine works on brain cell receptors linked to impulsive behaviors, while prazosin targets receptors associated with cravings.

Speaking in an American Psychiatric Association news release, Aubin noted that current medications for alcohol use disorder offer only "limited-to-moderate" effectiveness, so any additional treatment options are welcome.

The new study was published recently in the journal Addiction.

The research involved 154 adults diagnosed with severe alcoholism. That means they drank at least 60 grams of alcohol per day for men or 40 grams per day for women (at least three or four drinks daily). A standard bottle of beer, glass of wine, or shot of liquor contain 14 grams of alcohol.

Participants were divided into three groups: They received daily doses of dummy placebo pills; a "high dose" combo of prazosin plus cyproheptadine; or a "low dose" combo of prazosin plus cyproheptadine for 12 weeks.

Everyone also received support in terms of advice on adhering to the drug therapy and reducing their alcohol intake.

Aubin's team focused at alcohol intake reduction as their goal, not total abstinence.

Folks taking the two-drug regimen did see their alcohol intake decline compared to those on placebo, and the higher the dosage, the bigger the decline.

For example, people taking low-dose prazosin/cyproheptadine experienced an average 18.4 gram reduction in daily alcohol intake (compared to placebo), while those on the higher dose experienced an average 23.6 gram reduction.

The regimen was also tested among a subgroup of people with alcohol used disorder who drank a lot -- more than 100 grams of alcohol (at least 7 drinks) for men and 60 grams per day for women

In this group, taking high-dose prazosin/cyproheptadine cut daily intake by almost 30 grams of alcohol daily, the study found.

As for side effects, the drugs appeared to be "well tolerated," the researchers said.

“The promising efficacy of the combination of prazosin and cyproheptadine warrants prolonging this work with phase 3 trials,” they concluded.

More information

Find out more about the treatment of alcohol use disorder at the Mayo Clinic.

SOURCE: American Psychiatric Association, news release, April 17, 2024