Common medications may treat alcohol addiction

Alcohol addiction has long resisted easy treatment. Many people try to quit. Some succeed, but most relapse. The current medications on the market work for only a few.

Other drugs cause side effects that are bad enough to make people quit treatment altogether. For decades, scientists have searched for something better, something more effective, something people can actually stick with.

Now, a team of researchers from Sweden might have found a new path. Not with a brand-new molecule or an expensive designer drug. Instead, they reached into the medicine cabinet and pulled out two drugs we already know well.

Varenicline is used to help smokers quit and Bupropion is used for depression and nicotine withdrawal. Neither of these drugs were designed to treat alcohol use disorder, but something remarkable happened when researchers combined them.

Alcohol addiction treatments

Alcohol use disorder kills. Not slowly, either. Severe cases can cut lifespans by more than 25 years. Treatments exist, but they’re not doing enough.

Medications like disulfiram and naltrexone have been available for years, but their impact is limited. They help some people, but not the majority. The effects are modest, and many patients either don’t begin treatment or fail to stick with it.

Doctors and researchers have been hunting for something better. This time, they looked at the brain’s dopamine system. People with AUD may not get enough dopamine. That shortage could be what drives them to drink. So, what if we boosted dopamine instead?

Testing the drugs for alcohol addiction

That’s where varenicline and bupropion come in. Varenicline nudges nicotine receptors, releasing dopamine. Bupropion stops dopamine from fading too fast. Put them together and you get a one-two punch.

Bo Söderpalm, co-lead author of the study, is an expert in the Institute of Neuroscience and Physiology at the University of Gothenburg.

“We observed approximately twice the effect compared to currently available medications, which is highly promising. However, additional studies are required before the combination treatment can be approved for alcohol use disorder,” noted Söderpalm.

The researchers recruited 384 adults with moderate to severe alcohol use disorder. The individuals received one of four treatments: varenicline plus bupropion, one of the two drugs, or a placebo.

The trial lasted 13 weeks. The scientists didn’t just ask people how much they drank. They tested blood for B-PEth, a marker that tracks alcohol use. They also looked at how many days people drank heavily.

Drug combo reduced drinking

In nearly every measure, the drug duo outperformed the rest. In the group that followed treatment closely, alcohol addiction symptoms dropped the most. Blood tests showed significant improvements.

Self-reports did too. Total drinking went down, along with the number of heavy drinking days. Varenicline alone worked, but not as well. Bupropion alone did not make a meaningful difference.

Varenicline works, but it makes people nauseous. The study revealed something interesting. Bupropion seems to take the edge off. Fewer people got nauseous when they took both drugs. When they did feel sick, it didn’t last as long.

“Nausea is a well-known and troublesome side effect of treatment with varenicline. It was surprising but very encouraging to see that nausea decreased when bupropion was added,” noted study co-lead author Andrea de Bejczy.

“The fact that the combination treatment is more tolerable for patients increases the chances that they will complete the full course of treatment.”

Drinking less alcohol lowered health risks

The team went further. They used earlier research to estimate what the drop in drinking means for health.

The analysis showed that if the average person kept drinking less, their risk of dying from alcohol-related causes could fall by as much as 70 to 76 percent.

Individuals tolerated the drug combo well, and serious side effects were rare. The most common complaints were headache, insomnia, and fatigue, and they happened about equally in all groups.

Two old drugs offer new hope

The study didn’t include people fresh out of detox, so we don’t know how well the combo helps folks stay sober. Also, the team didn’t get to track nicotine use the way they planned. Supply issues blocked testing.

Still, the study stands out. It’s the first to use B-PEth as a main measure in a human trial for AUD. That matters. People often underreport drinking. Blood doesn’t lie.

These two drugs were never meant for alcohol addiction. But together, they just might be what many people need. The results show strong effects, fewer side effects, and better chances that people will actually finish treatment.

The study is published in the journal The Lancet Regional Health – Europe.

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