Aldosterone-Mineralocorticoid Pathway Linked To Craving For Alcohol Interview with:

Lorenzo Leggio, M.D., Ph.D. Chief of the Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, a NIAAA intramural laboratory 

Dr. Leggio

Lorenzo Leggio, M.D., Ph.D.
Chief of the Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, a NIAAA intramural laboratory What is the background for this study? What is the background for this study? What are the main findings?

Response: Aldosterone is an important hormone involved in the control of blood pressure and electrolytes via its mineralcorticoid receptor (MR). In addition to its roles in the periphery in our body, aldosterone also acts on the brain where the MR is particularly present in regions like the amygdala. The amygdala plays an important role in stress, anxiety and excessive alcohol drinking. Back in 2008, we conducted a small pilot study where we found that alcohol-dependent patients with higher blood aldosterone concentrations have higher alcohol craving.

Response: In the present study in Molecular Psychiatry, we studied aldosterone and MR in three different species, namely a monkey model of excessive alcohol use, a rat model of alcohol dependence and alcohol-dependent patients.

We found that aldosterone concentrations increased over time in non-human primates that self-administered alcohol daily for 6-12 months. We also found that the lower was the expression of the MR gene in their amygdala, the higher was their alcohol drinking. When we looked at the amygdala of dependent rats, we found similar results. Additionally, the lower the expression of the MR gene in the rat amygdala, the higher their anxiety-like behavior (in addition to alcohol drinking).

Finally, in alcohol-dependent patients, we found that those patients with higher blood concentrations of aldosterone also had higher craving for alcohol, higher anxiety and consumed more alcohol. What should readers take away from your report?

  • The aldosterone pathway and its MR receptor may represent a novel target to develop pharmacological treatments for patients with alcohol use disorder
  • Neuroendocrine pathways may shed light on the mechanisms of how some individuals drink excessive amounts of alcohol
  • Translational research and team efforts are important to move science What recommendations do you have for future research as a result of this study?

Response: This study is an initial step towards a better understanding of the role of aldosterone and its MR receptor in alcohol drinking. It is now important to investigate the potential causality link by conducting preclinical studies and then, if appropriate, clinical studies with the ultimate goal of investigating whether this initial information may eventually lead to better treatments for our patients with alcohol use disorder. Is there anything else you would like to add?

Response: This was a team effort among preclinical and clinical groups with expertise in different but complementary disciplines Thank you for your contribution to the community.


Mol Psychiatry. 2017 May 2. doi: 10.1038/mp.2017.97. [Epub ahead of print]

A relationship between the aldosterone-mineralocorticoid receptor pathway and alcohol drinking: preliminary translational findings across rats, monkeys and humans.

Aoun EG1, Jimenez VA2,3, Vendruscolo LF4, Walter NAR2,3, Barbier E5, Ferrulli A6, Haass-Koffler CL7,8,9, Darakjian P3, Lee MR9, Addolorato G6, Heilig M5, Hitzemann R3, Koob GF4, Grant KA2,3, Leggio L8,9.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


Last Updated on July 17, 2017 by Marie Benz MD FAAD