Enalapril Does not Decrease Alcohol Intake in Normotensive Alcoholics

Abstract

Some studies in rats have found that angiotensin converting enzyme (ACE) inhibitors, e.g., enalapril (E), decrease alcohol intake. Therefore, we tested E in normotensive moderately dependent drinkers, (36 male, 6 female), aged 24 to 65 years, consuming 8.2+2.3 (${\bar x}$+S.D.) standard alcoholic drinks per day. They were randomized to receive E 10 mg/day (n=20) or E 20 mg/day (n=22) and placebo (P) for 4 weeks each in a double-blind, crossover study. Patients monitored their alcohol intake, but received no other treatment. E 10 mg/day and P decreased mean daily drinks (${\bar x}$+SEM) from baseline (8.1+0.5) to 7.5+0.5 and 7.2+0.5, respectively, (both p<0.05). The effects of E 10 mg/day and P did not differ. Decreases from baseline were also observed with E 20 mg/day (from 8.3+0.5 to 6.8+0.6, p<0.01) and its P (to 7.2+0.4, p<0.01), but the effects of E 20 mg/day and P did not differ. Responses varied: 14 (64%) of E 20 mg/day patients decreased their alcohol intake by 21% (range=1.6% to 78.3%) compared with P. Plasma renin activity increased from P with E 10 and E 20 mg/day (both p<0.05). Blood pressure decreased within the normotensive range, except for one patient who discontinued the study because of hypotension after 5 days of E 10 mg. Otherwise, side effects were few and mild. No variables correlated with changes in alcohol intake. Our findings suggest that enalapril may not be a potential treatment for alcoholism.