Pregnenolone for Cocaine Addiction: Does it Help?

observational-study PMID: 36358943

Quick Summary: A recent study found that pregnenolone, a natural hormone, may help reduce cravings and anxiety in people with cocaine use disorder. The higher dose also lowered stress-related physical responses like heart rate and blood pressure.

What The Research Found

This study looked at how pregnenolone affects people struggling with cocaine addiction. Researchers found that taking pregnenolone helped:

Reduce cravings: People felt less urge to use cocaine when exposed to stress or reminders of cocaine.

Lower anxiety: Participants reported feeling less anxious when faced with stress or cocaine cues.

Calm the body: The higher dose of pregnenolone helped lower heart rate and blood pressure during stressful situations.

Study Details

Who was studied: 30 people seeking treatment for cocaine use disorder.

How long: Participants took pregnenolone or a placebo (dummy pill) for 8 weeks. Researchers measured effects after 2 weeks.

What they took: Participants took either 300mg or 500mg of pregnenolone daily.

What This Means For You

If you're struggling with cocaine addiction, this research suggests pregnenolone might help manage cravings and anxiety. However, it's important to remember:

Talk to your doctor: Don't start taking pregnenolone without talking to your doctor first. It can interact with other medications.

Not a cure: This study doesn't mean pregnenolone is a cure for addiction. It may be a helpful addition to other treatments like therapy.

More research needed: This is just one small study. More research is needed to confirm these findings and understand the long-term effects.

Study Limitations

It's important to be aware of the study's limitations:

Small group: The study only included 30 people, so the results may not apply to everyone.

Short-term results: The study only looked at the effects after 2 weeks, even though the treatment lasted 8 weeks.

Mostly men: Most participants were men, so the results might be different for women.

Self-reported data: The study relied on people reporting their own feelings, which can be subjective.

No relapse data: The study didn't track whether pregnenolone helped people stay off cocaine long-term.

Key Findings

Pregnenolone (PREG) significantly decreased stress- and cocaine cue-induced craving and anxiety in individuals with cocaine use disorder (CUD). At 500 mg/day, PREG also reduced stress-related autonomic arousal (heart rate, systolic and diastolic blood pressure). Both doses (300 mg and 500 mg) elevated serum pregnenolone levels compared to placebo.

Study Design

This was an observational study conducted in 2022 with a randomized, counterbalanced, within-subject design. Thirty treatment-seeking CUD participants (21 males, 9 females) were randomized to receive placebo (PBO) or PREG at 300 mg/day or 500 mg/day for 8 weeks. After 2 weeks of treatment, participants underwent three 5-minute guided imagery sessions (stress, cocaine cue, neutral) on separate days. Outcomes were measured pre- and post-provocation.

Dosage & Administration

Participants received daily oral doses of either 300 mg or 500 mg of pregnenolone. The supplement was administered for 8 weeks, with assessments conducted after 2 weeks of treatment initiation.

Results & Efficacy

Pregnenolone levels: Both PREG doses significantly increased serum pregnenolone vs. PBO (data not quantified in summary).
Craving reduction: Both 300 mg and 500 mg groups showed decreased stress- and cocaine cue-induced craving (p < 0.05, unspecified effect sizes).
Anxiety reduction: Only the 500 mg group exhibited significant reductions in stress- and cue-induced anxiety (p < 0.05).
Autonomic effects: The 500 mg group had lower stress-induced heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) (p < 0.05 for all).
Placebo: No significant changes in craving, anxiety, or autonomic measures were observed in the PBO group.

Limitations

Small sample size (n=30), limiting generalizability and statistical power.
Short duration: Assessments occurred after only 2 weeks of treatment, despite an 8-week intervention period, leaving long-term effects unexamined.
Gender imbalance: Male participants outnumbered females (21 vs. 9), potentially confounding results.
Self-reported outcomes: Craving and anxiety measures relied on subjective ratings, increasing bias risk.
No relapse follow-up: Study did not evaluate whether reduced craving/anxiety translated to lower relapse rates.
Mechanistic gaps: How PREG modulates stress biology in CUD remains unclear.

Clinical Relevance

For individuals with CUD, pregnenolone—particularly 500 mg/day—may help mitigate stress- and cue-induced cravings and anxiety, alongside dampening physiological arousal. However, these findings are preliminary and do not support standalone use; PREG should be considered as a potential adjunct to behavioral therapies. Supplement users without CUD should not extrapolate these results, as efficacy for general anxiety or stress management remains unproven. Further research is needed to confirm safety, optimal dosing, and long-term outcomes.

Note: Always consult a healthcare provider before using pregnenolone, as it may interact with hormonal pathways or medications.