Dutasteride as a Promising Option to Decrease Heavy Drinking

Current pharmaceutical options to decrease heavy alcohol use are limited; dutasteride, a 5-alpha-reductase inhibitor—normally used for prostate conditions—might be a good candidate. Researchers conducted a 12-week parallel-group randomized controlled trial among adults aged ≥35 years with alcohol use disorder (AUD) and heavy alcohol use* who wanted to decrease or stop their drinking. Participants were randomized to receive either dutasteride 1 mg daily or a placebo. All participants received bi-weekly medical management.

• Participants (N=167) were 95 percent White and 44 percent female; the average age was 56 years.
• Compared with placebo, participants receiving dutasteride experienced greater reductions in the number of heavy drinking days (40 percent decrease with dutasteride versus 23 percent decrease with placebo).
• Participants receiving dutasteride also consumed fewer drinks per week, compared with placebo (32 percent decrease with dutasteride versus 16 percent with placebo).
• Analyses stratified by sex showed statistically significant effects in men but not in women; women receiving placebo had a greater drinking reduction than men receiving placebo.
• There were no serious adverse events and no study withdrawal due to side effects.

* Defined as ≥24 drinks in a week for men and ≥18 drinks in a week for women with at least two heavy drinking days in a week.

Comments: Among people with AUD with a drinking reduction goal, dutasteride was well tolerated and significantly reduced heavy drinking and total alcohol use, especially in the men in this cohort, which was predominantly White. Effects were non-significant among women, but women in the placebo group showed a greater decrease. Effect sizes were comparable to currently approved medications. Further study is warranted, especially among racially diverse populations.

Nicolas Bertholet, MD, MSc

Reference: Covault J, Tennen H, Feinn R. Dutasteride as a treatment to support reduced drinking: a randomized placebo-controlled trial. J Addict Med. 2025 [Epub ahead of print]. doi: 10.1097/ADM.0000000000001609.