June 13, 2023 – Might the category of recent weight reduction medication together with semaglutide – permitted as Ozempic to deal with sort 2 diabetes and Wegovy to deal with weight problems – additionally curb addictions and compulsive behaviors?
As demand for semaglutide for weight reduction grew after Wegovy was permitted by the FDA in June 2021, private accounts of sudden added advantages additionally started to floor for the category of medicines often called GLP-1s, which mimic a pure hormone referred to as glucagon-like peptide-1 that helps an individual really feel full.
Some sufferers taking these medication for sort 2 diabetes or weight reduction additionally misplaced curiosity in addictive and compulsive behaviors akin to consuming alcohol, smoking, buying, nail biting, and pores and skin choosing, as reported in articles in The New York Occasionsand The Atlantic, amongst others. For now, the stories are merely anecdotal, in order that they’re subjective and never but clinically verified. However there’s additionally some early analysis to help these observations.
Latest and Upcoming Research
“I hope that GLP-1 analogs sooner or later can be utilized towards [alcohol use disorder], however earlier than that may occur, a number of GLP-1 trials [are needed to] show an impact on alcohol consumption,” mentioned Anders Fink-Jensen, MD, the senior creator of a latest randomized managed trial of 127 sufferers with alcohol use dysfunction, or AUD.
His examine concerned sufferers receiving 26 weeks of the first-generation GLP-1 agonist exenatide permitted for sort 2 diabetes, however this didn’t cut back the variety of heavy consuming days, in comparison with a placebo.
However in analyses executed after the examine ended, heavy consuming days and complete alcohol consumption had been considerably decreased within the subgroup of sufferers with AUD and weight problems as decided by a physique mass index, or BMI, over 30.
The individuals had been additionally proven footage of alcohol or impartial topics whereas that they had practical magnetic resonance imaging (MRI). Those that had obtained exenatide vs. a placebo had considerably much less activation of their brains’ reward facilities when proven the photographs of alcohol.
This reveals that “one thing is occurring within the mind and activation of the reward middle is hampered by the GLP-1 compound,” mentioned Fink-Jensen, a scientific psychologist on the Psychiatric Centre Copenhagen in Denmark.
“If sufferers with AUD already fulfill the standards for semaglutide (or different GLP-1 analogs) by having sort 2 diabetes and/or a BMI over 30, they’ll after all use the compound proper now,” he mentioned.
His group can also be starting a examine, in sufferers with AUD and a BMI of 30 or above, to analyze the consequences of semaglutide as much as 2.4 milligrams weekly on alcohol consumption. That is the utmost dose of semaglutide permitted for weight problems within the U.S.
“Based mostly on the efficiency of exenatide and semaglutide,” Fink-Jensen mentioned, “we anticipate that semaglutide will trigger a stronger discount in alcohol consumption” than exenatide.
Animal research have additionally proven that GLP-1 agonists suppress alcohol-induced reward, alcohol consumption, motivation to devour alcohol, alcohol searching for, and relapse consuming of alcohol, in line with researcher Elisabet Jerlhag Holm, PhD.
These brokers additionally suppress the reward, consumption, and motivation to devour different addictive medication like cocaine, amphetamine, nicotine, and a few opioids, mentioned Jerlhag Holm, a professor within the Division of Pharmacology on the College of Gothenburg in Sweden.
Her group lately printed outcomes of a examine executed in rats that gives proof to assist clarify the anecdotal stories from sufferers with weight problems handled with semaglutide who claimed in addition they decreased their alcohol consumption. Within the examine, semaglutide each decreased alcohol consumption (and relapse-like consuming) and decreased physique weight of rats of each sexes.
“Future analysis ought to discover the opportunity of semaglutide lowering alcohol consumption in sufferers with AUD, notably those that are obese,” Jerlhag Holm mentioned.
“AUD is a … dysfunction [involving various components], and one treatment is most definitely not useful for all AUD sufferers,” she mentioned, “and subsequently an arsenal of various drugs is useful when treating AUD sufferers.”
Janice J. Hwang, MD, MHS, echoed these ideas.
“Anecdotally, there are quite a lot of stories from sufferers (and within the information) that this class of treatment impacts cravings and will influence addictive behaviors,” she mentioned.
Nonetheless, “I feel it’s a lot too early to inform” whether or not these medication is perhaps permitted for treating sufferers for addictions with out extra strong scientific trial information, mentioned Hwang, an affiliate professor of medication and chief of the Division of Endocrinology and Metabolism on the College of North Carolina at Chapel Hill.
In the meantime, one other analysis group on the College of North Carolina at Chapel Hill, led by psychiatrist Christian Hendershot, PhD, is conducting a scientific trial in 48 individuals with AUD who’re additionally people who smoke.
They goal to find out if sufferers who obtain semaglutide photographs at more and more larger doses over 9 weeks will drink much less alcohol and smoke lower than those that obtain a placebo shot. Outcomes are anticipated in October.