Citation

Covault J, Tennen H, Feinn R. J. Clin. Psychopharmacol. 2024; 44(3): 223-231.

Copyright

(Copyright © 2024, Lippincott Williams and Wilkins)

DOI

10.1097/JCP.0000000000001849

PMID

38684046

Abstract

BACKGROUND: Prior studies indicate that neuroactive steroids mediate some of alcohol's effects. Dutasteride, widely used to treat benign prostatic hypertrophy, is an inhibitor of 5-alpha reductase enzymes, which play a central role in the production of 5α-reduced neuroactive steroids. The purpose of this study was to test dutasteride's tolerability and efficacy for reducing drinking.

METHODS: Men (n = 142) with heavy drinking (>24 drinks per week) and a goal to either stop or reduce drinking to nonhazardous levels were randomized to placebo or 1 mg dutasteride daily for 12 weeks. We hypothesized that dutasteride-treated patients would be more successful in reducing drinking.

RESULTS: Generalized linear mixed models that included baseline drinking, treatment, time and their 2-way interaction identified significant interactions of treatment-time, such that dutasteride treatment reduced drinking more than placebo. During the last month of treatment, 25% of dutasteride-treated participants had no hazardous drinking (no heavy drinking days and not more than 14 drinks per week) compared with 6% of placebo-treated participants (P = 0.006; NNT = 6). Sensitivity analysis identified baseline drinking to cope as a factor associated with larger reductions in drinking for dutasteride compared with placebo-treated participants. Dutasteride was well tolerated. Adverse events more common in the dutasteride group were stomach discomfort and reduced libido.

CONCLUSION: Dutasteride 1 mg daily was efficacious in reducing the number of heavy drinking days and drinks per week in treatment-seeking men. The benefit of dutasteride compared with placebo was greatest for participants with elevated baseline drinking to cope motives.

Language: en

Keywords

*5-alpha Reductase Inhibitors/pharmacology/administration & dosage/adverse effects; *Alcohol Drinking/drug therapy; *Dutasteride/pharmacology/administration & dosage/adverse effects; Adult; Aged; Azasteroids/pharmacology/administration & dosage/therapeutic use/adverse effects; Double-Blind Method; Humans; Male; Middle Aged; Treatment Outcome