Source: United Kingdom – Executive Government & Departments
A study published in JAMA Psychiatry looks at the use of semaglutide in adults with alcohol use disorder.
Dr Riccardo De Giorgi, Clinical Lecturer at the Department of Psychiatry, University of Oxford, said:
“There has been much sensation (and even more noise) about GLP-1 drugs such as semaglutide in the medical field, especially regarding mental health. However, their potential use as a mechanistically novel treatment for addiction is perhaps one of the most promising research avenues. This investigator-initiated phase 2 randomised, placebo-controlled trial was small (48 people) but sound and well-designed. It looked at several outcomes of importance to alcohol misuse. It represents, at present, the most robust and yet preliminary piece of evidence suggesting that these medications may indeed be useful for the care of people with alcohol use disorder – an extremely disabling condition. Semaglutide appeared to be safe and well-tolerated, though it should be noted that the administered dose was not large (0.5mg) and it was given over a relatively short period of time (8 weeks). This is the kind of study of which we need to see more if we are to see progress in this key research area.”
Prof Matt Field, Professor of Psychology, University of Sheffield, said:
“Some recent research suggests that semaglutide can reduce alcohol consumption in people with alcohol use disorders. Those studies were observational, which means it is difficult to attribute the reduction in alcohol consumption to semaglutide rather than to confounding factors. The present study overcomes these limitations by randomising adults with alcohol use disorder to receive weekly injections of either low-dose semaglutide or placebo over 9 weeks. Participants recorded how much alcohol they drank over this period, and they also completed laboratory sessions at the beginning and end of the study period in which they could consume alcoholic drinks. The research team found that, compared to the placebo group, the group who had received semaglutide drank significantly less alcohol in the lab. Furthermore, although the semaglutide and placebo groups did not differ in how often they drank alcohol during the study period (outside the lab), on days when they did drink alcohol the semaglutide group drank less alcohol than the placebo group.
“Overall, this randomised study goes beyond previous observational studies which tended to look at people who were prescribed semaglutide for other reasons (usually diabetes) and evaluate how the drug affected their alcohol consumption. With those types of observational studies, it is difficult to know if any effects on alcohol consumption were attributable to the drug or to confounding factors. This study overcomes those limitations by demonstrating, for the first time, a causal effect of semaglutide on the amount of alcohol that people drink. This study will hopefully serve as a springboard for further research. Furthermore, the nature of the semaglutide effect (reducing the amount of alcohol consumed, whilst having no effect on the number of days that people drank alcohol) is consistent with the idea that semagludide reduces the reward or pleasure that people get from drinking alcohol, which is why they drink less.
“Some limitations of the study include the characteristics of the sample, who were not seeking treatment and were not motivated to reduce their alcohol consumption or stop drinking. Most new treatments for alcohol use disorder are evaluated in people who ask for treatment because they want help to stop drinking altogether or reduce their drinking, so it will be important to test the effects of semaglutide on people with these characteristics. A cautionary tale is that, when promising medications are tested in people with alcohol use disorder who are trying to cut down their drinking, we often see a large placebo response (i.e. a reduction in drinking among people taking placebo), which can obscure any additional effect of the drug. Other considerations are that participants in this study had a body mass index (BMI) of at least 23, and most had a BMI of 30 or higher (which is in the obese range). It will be important to establish if semaglutide can also reduce alcohol consumption in people who are not obese, particularly given that many people who seek treatment for alcohol problems are underweight. This study had a small sample size and a short follow-up period, so it will be important to see if the effects of semaglutide are maintained over a longer time period, and, crucially, what happens when people stop taking the medication. It will also be important to consider if and how semaglutide can be incorporated into conventional treatment for alcohol use disorder which might include detoxification, counselling or talking therapies, other types of medications, and involvement with mutual aid groups such as alcoholics anonymous.”
‘Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial’ by Christian S. Hendershot et al. was published in JAMA Psychiatry at 16:00 UK time on Wednesday 12 February 2025.
DOI: 10.1001/jamapsychiatry.2024.4789
Declared interests
Dr Riccardo De Giorgi: “I am supported by the NIHR Oxford Health Biomedical Research Centre and currently conduct research on GLP-1 medications (NIHR OH BRC funded; no industry or any other kind of funding).”
Prof Matt Field: “I have no conflicts of interest to declare.”