- Six patients treated with semaglutide experienced reductions in alcohol use disorder (AUD) symptoms.
- Experts say it may have helped due to semaglutide’s effects on dopamine.
- Dopamine is the “pleasure” hormone that makes drinking alcohol feel good.
- More research is needed before semaglutide becomes a treatment for AUD.
- Experts say it may be worth a try now if you already have other indications for its use.
According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use disorder (AUD) is a brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.
People with this disorder have a reduced ability to stop or control their drinking even though it is having negative effects on their lives.
Currently, AUD has only three FDA-approved drug treatments: acamprosate, disulfiram, and naltrexone.
However, a new case series that was published on November 27, 2023, in The Journal of Clinical Psychiatry, presents new evidence that semaglutide — commonly used for applications such as diabetes management and weight loss — may also be useful in the treatment of AUD.
The case series, which included six patients, involved people who had positively screened for AUD.
All patients were being treated with semaglutide, the active ingredient in both Ozempic and Wegovy, for weight loss.
However, it was found that these people incidentally had improvement in their AUD symptoms which was described in an associated press release from the University of Oklahoma as “remarkable.”
During follow-up, all six patients had AUDIT (alcohol use disorders identification test) scores that indicated “low-risk” drinking, according to the report. This would generally indicate that a person does not have a problem with drinking.
The study authors caution, however, that randomized, placebo-controlled clinical studies are needed to verify whether semaglutide is a viable treatment for AUD. But, they say there is a strong potential for it to become another effective tool to help treat this disorder.
Why might semaglutide reduce the desire for alcohol?
Dr. Alexandra Sowa of SoWell Health, who is a board-certified obesity medicine expert and a clinical instructor of medicine at NYU, explained that it’s not surprising that a drug used to treat diabetes and obesity might also affect AUD.
“GLP-1 medications don’t just work on the stomach,” she said, “they touch every organ, from the heart to the brain.
“We have known for a long time that dopamine is the ‘pleasure’ hormone that becomes overly activated in addiction, be it addiction to food, alcohol or even video games,” Sowa added.
“GLP-1 medications reduce the release of dopamine, making previously ‘rewarding’ behaviors, like over-drinking, far less enjoyable,” she explained.
Dr. Jonathan Kaplan, a board-certified plastic surgeon and owner of Pacific Heights Plastic Surgery, added that we’ll probably also see it being utilized to treat other “OCD-like tendencies” including nail biting, online shopping, smoking, or vaping.
What about the long-term effects of semaglutide?
Given that AUD is not a curable condition, it is likely that a person would need to remain on semaglutide throughout their life in order to control their symptoms. So, what do we know about its long-term effects?
Kaplan said, “This class of drugs have been around for 20+ years so we do know the most common side effects are GI in nature (nausea, vomiting, constipation and diarrhea).”
Long-term side effects can include medullary thyroid cancer, he added. However, he pointed out that this was mostly seen in lab rats and not humans.
“In fact, medullary thyroid cancer in humans has remained rare and unchanged for 30+ years,” said Kaplan.
He concluded by saying that the benefits of semaglutide appear to outweigh the risks when it comes to AUD.
Should people with AUD use semaglutide now?
Sowa said that it’s too early to say how well semaglutide will actually work for AUD, including when it comes to long-term sobriety.
“I wouldn’t recommend semaglutide for AUD in isolation, but if a patient meets BMI or blood sugar criteria for use, and over-drinking is an issue, it’s a win-win medication,” she stated.
Kaplan agreed with Sowa, noting that this study only included six case studies.
“Hundreds or thousands of patients would be the gold standard type of study needed before declaring ‘success’ and recommending this as sole treatment,” he declared. “But it’s certainly promising, and at this time, no reason not to try it.”
Takeaway
Alcohol use disorder (AUD) is a brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.
Currently, only three drug treatments exist for AUD. However, a small study involving six patients found that semaglutide had a “remarkable” ability to reduce people’s AUD symptoms.
This could be because of its ability to affect the “pleasure” hormone dopamine, making drinking a less rewarding experience.
While larger studies are needed to determine whether semaglutide will become a treatment for AUD, experts say it’s “promising” and might be worth a try, especially if you already have other approved indications for its use, such as diabetes or obesity.
Ozempic and Wegovy Show Promise for Treating Alcohol Use Disorder
Source: Pinoy Lang Sakalam
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