Prazosin Moderates Drinking For People With Alcohol Withdrawl


Prazosin, a drug once used to treat high blood pressure, can help alcoholics who are experiencing withdrawal symptoms to reduce or eliminate their drinking, researchers report.

There has been no treatment readily available for people who experience severe withdrawal symptoms and these are the people at highest risk of relapse and are most likely to end up in hospital emergency rooms,”

said Rajita Sinha, a professor of psychiatry and neuroscience, director of the Yale University Stress Center, and corresponding author of the paper1.

The drug had minimal effect on those with few or no withdrawal symptoms.

Alcohol Use Disorder

The double-blind study involved giving the drug prazosin or a placebo to 100 people entering outpatient treatment after receiving an alcohol use disorder diagnosis. All of the patients had experienced varying degrees of withdrawal symptoms prior to entering treatment.

Subjects with more severe symptoms — including shakes, heightened cravings and anxiety, and difficulty sleeping — who received prazosin significantly reduced the number of heavy drinking episodes and days they drank compared to those who received a placebo.

Prazosin was developed for treating high blood pressure and it is still used to treat prostate problems in men, among other conditions. Earlier research conducted at Yale showned that the drug works on stress centers in the brain and helps to improve working memory and curb anxiety and craving.

Constant Craving

Sinha’s lab has shown that stress centers of the brain are severely disrupted early in recovery, especially for those with withdrawal symptoms and high cravings, but that the disruption decreases the longer the person maintains sobriety.

Prazosin could help bridge that gap by moderating cravings and withdrawal symptoms earlier in recovery and increasing the chances that patients refrain from drinking, she says.

One drawback – in its current form prazosin needs to be administered three times a day to be effective, Sinha notes.

  1. Rajita Sinha, Stephanie Wemm, Nia Fogelman, Verica Milivojevic, Peter M. Morgan, Gustavo A. Angarita, Gretchen Hermes, and Helen C. Fox
    Moderation of Prazosin’s Efficacy by Alcohol Withdrawal Symptoms
    American Journal of Psychiatry 19 Nov, 2020 ↩︎