Randomized Placebo-Controlled Clinical Trial of Dutasteride for Reducing Heavy Drinking in Men

Area of Science:

• Neuroscience
• Pharmacology
• Addiction Medicine

Background:

• Neuroactive steroids influence alcohol's effects.
• Dutasteride inhibits 5-alpha reductase, reducing 5α-reduced neuroactive steroids.
• This study investigates dutasteride for alcohol use reduction.

Purpose of the Study:

• To assess dutasteride's tolerability and efficacy in reducing alcohol consumption.
• To determine if dutasteride treatment leads to greater reductions in drinking compared to placebo.

Main Methods:

• 142 men with heavy drinking were randomized to 12 weeks of placebo or 1 mg dutasteride daily.
• Participants aimed to stop or reduce drinking to non-hazardous levels.
• Generalized linear mixed models analyzed drinking reduction.

Main Results:

• Dutasteride significantly reduced drinking more than placebo.
• 25% of dutasteride users achieved non-hazardous drinking vs. 6% on placebo (P=0.006).
• Reduced libido and stomach discomfort were more common with dutasteride.

Conclusions:

• Dutasteride (1 mg daily) effectively reduced heavy drinking days and overall drinks per week in men seeking treatment.
• The drug was well-tolerated.
• Individuals with higher "drinking to cope" motives showed the greatest benefit from dutasteride.