Could the class of new weight-loss drugs, including semaglutide, approved as Ozempic to treat type 2 diabetes and Wegovy to treat obesity, also reduce addictions and compulsive behaviors?
As demand for semaglutide for weight loss increased following the FDA's approval of Wegovy in June 2021, personal stories of additional unexpected benefits also began to emerge for the class of drugs known as GLP-1, which mimic a natural hormone called glucagon-like peptide. . -1 which helps the person feel full.
Some patients taking these medications for type 2 diabetes or weight loss have also lost interest in addictive and compulsive behaviors such as drinking alcohol, smoking, shopping, nail biting, and scratching. skin, as reported in articles in the New York Times and The Atlantic. , among others. . For now, the reports are purely anecdotal, so they are subjective and have not yet been clinically verified. But there is also some initial research that supports these
observations.Recent and future studies
“I hope that in the future, GLP-1 analogs can be used against [alcohol use disorders], but before that happens, several trials of GLP-1 are needed to demonstrate an effect on alcohol consumption,” said Anders Fink. Jensen. , MD, lead author of a recent randomized controlled trial involving 127 patients with alcohol use disorder or AUD.
Their study included patients who received exenatide, a first-generation GLP-1 agonist approved for type 2 diabetes, for 26 weeks, but it did not reduce the number of days of binge drinking , compared to a placebo.
But in analyzes conducted after the study ended, binge drinking days and total alcohol consumption were significantly reduced in the subgroup of patients with AUD and obesity, as determined by a body mass index, or BMI, greater than 30.
Participants also viewed photographs of alcoholic or neutral subjects while undergoing functional magnetic resonance imaging (MRI). Those who received exenatide compared to a placebo had significantly less activation of their brain's reward centers when they were shown images of alcohol.
This shows that "something is happening in the brain and the activation of the reward center is being hindered by the GLP-1 compound," said Fink-Jensen, a clinical psychologist at the Copenhagen Psychiatric Center in Denmark.
“If patients with AUD already meet the criteria for semaglutide (or other GLP-1 analogs) due to type 2 diabetes and/or a BMI greater than 30, they can of course use the compound right now,” he said.
His team is also launching a study, in patients with an AUD and a BMI of 30 or more, to study the effects of semaglutide up to 2.4 milligrams per week on alcohol consumption. This is the maximum dose of semaglutide approved for the treatment of obesity in the United States.
“Based on the potency of exenatide and semaglutide,” Fink-Jensen said, “we expect semaglutide to result in a stronger reduction in alcohol consumption” than exenatide.
Animal studies have also shown that GLP-1 agonists suppress alcohol-induced reward, alcohol consumption, motivation to consume alcohol, alcohol seeking, and recurrent alcohol use, according to researcher Elisabet Jerlhag Holm., Ph.D.
These agents also suppress the reward, consumption and motivation to use other addictive drugs such as cocaine, amphetamines, nicotine and some opioids, said Jerlhag Holm, a professor at the Department of Pharmacology at the University of Gothenburg in Sweden.
His group recently published results from a rat study that provide evidence to explain anecdotal reports of obese patients treated with semaglutide who also reported reducing their alcohol consumption. In the study, semaglutide reduced alcohol consumption (and relapse-type alcohol consumption) and decreased body weight in rats of both sexes.
“Future research should explore the possibility that semaglutide reduces alcohol consumption in patients with AUD, particularly those who are overweight,” said Jerlhag Holm.
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