Semaglutide Reduces Cravings in Adults with Alcohol Use Disorder
Nine weeks of low-dose semaglutide decreased the amount of alcohol consumed, relative to placebo, in a laboratory test involving adults with alcohol use disorder (AUD) who were not seeking treatment. Researchers reported findings from their phase 2 randomized clinical trial in JAMA Psychiatry.
“The focus on non–treatment-seeking participants has important considerations, one being that semaglutide-related reductions in drinking quantity occurred absent volitional attempts to reduce drinking,” wrote corresponding author Christian S. Hendershot, PhD, of the University of Southern California Keck School of Medicine, Los Angeles, California, and study coauthors.
Glucagon-like peptide 1 (GLP-1) receptor agonists have been linked with the potential to reduce alcohol intake in preclinical, observational, and pharmacoepidemiology reports. To investigate the significance of the evidence, researchers conducted a double-blind, parallel-arm, randomized clinical trial involving the GLP-1 receptor agonist semaglutide in 48 non–treatment-seeking adults with AUD. Participants received 9 weeks of semaglutide (0.25 mg/week for 4 weeks, 0.5 mg/week for 4 weeks, and 1.0 mg for 1 week) or placebo at weekly outpatient clinic visits.
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The primary outcome objectively considered voluntary alcohol consumption and ability to delay drinking. Before the first injection and after the last, participants were invited to a comfortable laboratory setting with their preferred alcoholic beverage and brand. They could chose to delay drinking for up to 50 minutes for a monetary reward. Afterward, they were free to consume alcohol at their preferred pace over 120 minutes.
According to the study, semaglutide reduced the amount of alcohol consumed in the laboratory test. Researchers reported medium to large effect sizes for grams of alcohol consumed and peak breath alcohol concentration. The study found no medication effects on delay time.
Compared with placebo, semaglutide also decreased weekly alcohol cravings and average drinks on drinking days, which were assessed during outpatient visits. Additionally, semaglutide predicted greater reductions in heavy drinking days over time. However, not all measures of weekly consumption, such as average drinks per calendar day and number of drinking days, improved with semaglutide.
In a subgroup of participants with cigarette use at baseline, semaglutide was linked with significantly greater reductions in average cigarettes per day compared with placebo.
“These findings provide initial prospective evidence that low-dose semaglutide can reduce craving and some drinking outcomes,” researchers wrote, “justifying larger clinical trials to evaluate GLP-1 receptor agonists for alcohol use disorder.”
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