Researchers at The University of Texas Health Science Center at Houston (UTHealth) are investigating if a medication used to regulate blood sugar can alter motivation to use alcohol by targeting the brain's stress response system.
Many people don't realize just how stressed and anxious they are, or that their alcohol use could be directly related to those conditions."
Jin Yoon, PhD, assistant professor in the Department of Psychiatry and Behavioral Sciences at McGovern Medical School at UTHealth
Researchers are looking to target the root causes of alcohol use, in this case related to stress and anxiety that might lead to drinking.
"Most of the approved medications for alcohol use work in one of three ways: blocking the rewarding effects of alcohol in the brain, altering the way it is broken down when consumed, or alleviating withdrawal symptoms," said Yoon, the principal investigator of the pilot study. "However, we know that elevated levels of stress and anxiety and alcohol use are related. We want to identify medicine that more directly and proactively targets stress-related processes, rather than the brain's reward center and dopamine pathways, to provide more effective treatment."
The medication being studied is pioglitazone, a drug commonly used to treat Type 2 diabetes that works by restoring the body's proper response to insulin. The study will assess whether it can also target the body's reaction to stress in the brain's peroxisome proliferator-activated receptors, which are proteins that exhibit both anti-inflammatory and neuroprotective responses.
"Pioglitazone may reduce alcohol use by altering some of the motivational factors driven by stress and anxiety that can make drinking rewarding," said Yoon. "We hope that the medicine reacts to inflammatory systems that can be set off when exposed to both chronic stress and consistent alcohol use. Regular alcohol use, along with drug use, can actually alter the body's stress response system and cause inflammation, prompting users to crave more of those substances. We hope this medication helps to right that cycle by reducing overall stress levels, as well as reducing the response to stimuli that evoke stress and/or anxiety."
The drug has been found to be successful at reducing alcohol consumption in animal studies, and a UTHealth study found that it can help treat cocaine addiction in people.
Participants are being recruited in the Houston area for this study through August. To qualify, you must be between the ages of 21 and 40, have no current medical conditions, have a history of stress and/or anxiety, and drink alcohol.
The study takes four weeks to complete, and requires a baseline screening, a daily commitment to take the medication, four weekly check-ins, and two stress assessments. The stress tests include the cold pressor test, where the participant will submerge their dominant hand into an ice bath for two minutes while researchers assess their cortisol levels, blood pressure, and overall stress response. Alcohol craving will be assessed using a questionnaire. Participants will be compensated for their participation and travel.
Schmitz, J.M. et al. (2019) PPAR-gamma agonist pioglitazone modifies craving intensity and brain white matter integrity in patients with primary cocaine use disorder: a double-blind randomized controlled pilot trial. Addiction. doi.org/10.1111/add.13868.