June 13, 2023 – Might the category of recent weight reduction medicine together with semaglutide – authorized as Ozempic to deal with kind 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 authorized 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 known as glucagon-like peptide-1 that helps an individual really feel full.
Some sufferers taking these medicine for kind 2 diabetes or weight reduction additionally misplaced curiosity in addictive and compulsive behaviors comparable to ingesting alcohol, smoking, procuring, nail biting, and pores and skin choosing, as reported in articles in The New York Occasionsand The Atlantic, amongst others. For now, the reviews are merely anecdotal, so that they’re subjective and never but clinically verified. However there’s additionally some early analysis to help these observations.
Current and Upcoming Research
“I hope that GLP-1 analogs sooner or later can be utilized in opposition to [alcohol use disorder], however earlier than that may occur, a number of GLP-1 trials [are needed to] show an impact on alcohol consumption,” stated 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 authorized for kind 2 diabetes, however this didn’t scale back the variety of heavy ingesting days, in comparison with a placebo.
However in analyses accomplished after the examine ended, heavy ingesting days and whole alcohol consumption have 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 members have been additionally proven photos of alcohol or impartial topics whereas that they had useful magnetic resonance imaging (MRI). Those that had acquired exenatide vs. a placebo had considerably much less activation of their brains’ reward facilities when proven the images of alcohol.
This reveals that “one thing is occurring within the mind and activation of the reward heart is hampered by the GLP-1 compound,” stated 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 kind 2 diabetes and/or a BMI over 30, they’ll after all use the compound proper now,” he stated.
His group can be starting a examine, in sufferers with AUD and a BMI of 30 or above, to research the results of semaglutide as much as 2.4 milligrams weekly on alcohol consumption. That is the utmost dose of semaglutide authorized for weight problems within the U.S.
“Based mostly on the efficiency of exenatide and semaglutide,” Fink-Jensen stated, “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 eat alcohol, alcohol in search of, and relapse ingesting of alcohol, in line with researcher Elisabet Jerlhag Holm, PhD.
These brokers additionally suppress the reward, consumption, and motivation to eat different addictive medicine like cocaine, amphetamine, nicotine, and a few opioids, stated Jerlhag Holm, a professor within the Division of Pharmacology on the College of Gothenburg in Sweden.
Her group not too long ago revealed outcomes of a examine accomplished in rats that gives proof to assist clarify the anecdotal reviews 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 ingesting) and decreased physique weight of rats of each sexes.
“Future analysis ought to discover the potential for semaglutide lowering alcohol consumption in sufferers with AUD, notably those that are obese,” Jerlhag Holm stated.
“AUD is a … dysfunction [involving various components], and one remedy is most definitely not useful for all AUD sufferers,” she stated, “and due to this fact an arsenal of various medicines is helpful when treating AUD sufferers.”
Janice J. Hwang, MD, MHS, echoed these ideas.
“Anecdotally, there are a whole lot of reviews from sufferers (and within the information) that this class of remedy impacts cravings and will influence addictive behaviors,” she stated.
Nonetheless, “I believe it’s a lot too early to inform” whether or not these medicine is likely to be authorized for treating sufferers for addictions with out extra stable scientific trial information, stated 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 folks with AUD who’re additionally people who smoke.
They purpose to find out if sufferers who obtain semaglutide pictures at more and more increased doses over 9 weeks will drink much less alcohol and smoke lower than those that obtain a placebo shot. Outcomes are anticipated in October.