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Prazosin cuts rate of drinking in patients with alcohol use disorder

10 Sep 2018
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The α-1 adrenergic receptor antagonist prazosin appears to be an effective treatment for alcohol use disorder, according to a recent study.

“Prazosin holds promise as a harm-reduction pharmacologic treatment for alcohol use disorder and deserves further evaluation by independent research groups,” the authors said.

A total of 92 participants with alcohol use disorder but without post-traumatic stress disorder were randomized to receive prazosin or placebo in a 12-week double-blind study. Medication was titrated to a target dosing of 4 mg in morning and in the afternoon and 8 mg at bedtime by the end of week 2.

Medical management was the behavioural platform. Data on alcohol consumption were provided by participants daily. The authors assessed the impact of prazosin vs placebo on number of drinks per week, number of drinking days per week and number of heavy drinking days per week using generalized linear mixed-effects models.

Of the participants, 80 completed the titration and were included in the primary analyses. A significant association was seen between condition and week for both number of drinks and number of heavy drinking days. Participants in the prazosin condition had a greater reduction in the rate of drinking and the probability of heavy drinking compared with those in the placebo condition over time.

In addition, there was a higher incidence of drowsiness and oedema among participants in the prazosin vs the placebo condition.

“Current medications for alcohol use disorder do not target brain noradrenergic pathways. Theoretical and preclinical evidence suggests that noradrenergic circuits may be involved in alcohol reinforcement and relapse,” the authors said.

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Most Read Articles
21 Aug 2019
Daily use of the selective oral Bruton’s tyrosine kinase inhibitor evobrutinib in the treatment of patients with relapsing multiple sclerosis helps reduce the number of gadolinium-enhancing lesions, according to the results of a phase II trial.
20 Aug 2019
The combination of pravastatin and sorafenib does not appear to improve survival in patients with hepatocellular carcinoma (HCC), a recent study has shown.
08 Jul 2017
Entecavir and lamivudine demonstrate comparable effects on the mortality rate of patients with chronic hepatitis B virus (HBV)-related acute exacerbation with or without acute-on-chronic liver failure (ACLF), reports a study. In patients with ACLF, however, entecavir delivers a more favourable long-term outcome and is associated with greater clinical improvements.
Roshini Claire Anthony, 20 Aug 2019

The combination of emtricitabine and dolutegravir with either a tenofovir alafenamide fumarate (TAF) or tenofovir disoproxil fumarate (TDF)-based regimen fared similarly to a TDF-emtricitabine-efavirenz regimen in reducing HIV-1 RNA levels, according to results of the phase III ADVANCE* study presented at IAS 2019.