Louisville Medicine Volume 73, Issue 1 | Page 22

Semaglutide:

Might Help Attenuate Abuse of Alcohol

by Ilnaz Alavi, MD & Steven Lippmann, MD

The U. S. has for many decades nicely been a leader at advanced medical innovation. However, our health care delivery and good outcome records here are often substandard. Beyond limited access and high financial cost issues, diabetes, obesity and alcohol abuse care are three persistent clinical problems for which we have long sought improvement.

The pharmacotherapy of diabetes mellitus has progressed greatly. The advent of glucagon-like peptide-1 receptor agonist drugs( GLP-1 RA) is a prominent example. Although our society is troubled by their expensive price, these medications are celebrated for their many therapeutic options. 1 GLP-1 RA medicines have also emerged with efficacy at reducing obesity among persons who are overweight. They might additionally improve the prognoses for individuals infected with COVID-19. 2 The management of excessive alcohol use remains a pathology without a uniformly consistent good intervention.
The incretin hormone, glucagon-like peptide 1, has a powerful role at influencing food intake satiation. GLP-1 RA pharmacotherapies have an effect at deceasing blood glucose concentrations and are a popular remedy for weight control. This yields atherosclerosis mitigation throughout the body. 1 They may also positively affect human behavior and mental illness manifestations. 3 New is that the GLP-1 RA drug, semaglutide, is also reported to help people diminish alcohol intake. 4
Semaglutide is thought to affect brain reward-dependent functions through action on GLP-1 receptors in the nucleus accumbens and ventral tegmental area. 5 Research indicates that prescribing it can diminish alcohol intake and consumption relapses, and might even minimize some aspects of ethanol withdrawal. 6 This potential application to the treatment of alcohol abuse was initially observed in animal studies 7 and seems to persist also among human subjects at curbing too much drinking.
Investigations document semaglutide as an effective means to decrease hospitalizations of people due to alcohol and other substance use disorders, even for those with suicide attempts. 8 Prognoses reportedly improved despite not reducing the number of drinking days. 9
Only time and clinical use experience will establish whether semaglutide is a welcome addition into the armamentarium for treating patients with alcohol abuse disorders. Further research is ongoing. Semaglutide appears to offer the potential for being a good therapeutic option for this otherwise refractory pathology.
References
1
Collins L, Costello R A. Glucagon-Like peptide-1 receptor agonists. 2024 Feb 29. StatPearls, National Center for Biotechnology Information Bookshelf: NBK551568. 2025. Last accessed April 19, 2025.
2
Scirica B M, Lincoff A M, Lingvay I, et al. The Effect of Semaglutide on Mortality and COVID-19-Related Deaths: An Analysis From the SELECT Trial. Journal of the American College of Cardiology. 2024.84( 17): 1632-1642.
3
Eren-Yazicioglu C Y, Yigit A, Dogruoz R E, et al. Can GLP-1 Be a Target for Reward System Related Disorders? A Qualitative Synthesis and Systematic Review Analysis of Studies on Palatable Food, Drugs of Abuse, and Alcohol. Frontiers in Behavioral Neuroscience. 2020,14: 614884. Last accessed April 19, 2025.
4
Quddos F, Hubshman Z, Tegge A, et al. Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity. Scientific Reports. 2023 Nov 28; 13( 1): 20998. Last accessed April 19, 2025.
5
Zheng Y J, Soegiharto C, Au H C T, et al. A systematic review on the role of glucagon-like peptide-1 receptor agonists on alcohol-related behaviors: potential therapeutic strategy for alcohol use disorder. Acta Neuropsychiatrica. 2025; 37: e51. Last accessed April 19, 2025.
6
Jerlhag E. GLP-1 Receptor Agonists: Promising Therapeutic Targets for Alcohol Use Disorder. Endocrinology. 2025, 166( 4): bqaf028. Last accessed April 19, 2025.
7
Aranäs C, Edvardsson C E, Shevchouk O T, et al. Semaglutide reduces alcohol intake and relapse-like drinking in male and female rats. EBioMedicine, 2023, 93: 104642. Last accessed April 19, 2025.
8
Lähteenvuo M, Tiihonen J, Solismaa A, et al. Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder. The Journal of the American Medical Association- Psychiatry. 2025, 82( 1): 94-98.
9
Hendershot C S, Bremmer M P, Paladino M B, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. The Journal of the American Medical Association- Psychiatry. 2025, 82( 4): 395-405.
Dr. Alavi is an international medical graduate from Iran, here now doing clinical rotations with physicians in Louisville. She hopes to gain residency next year in this country.( non-member)
Dr. Lippmann is a retired University of Louisville School of Medicine emeritus professor doing volunteer medical services at Louisville’ s Family Community Clinic. Dr. Lippmann and Dr. Alavi work together in this clinic and at a medical school scientific medical writing seminar.( non-member)
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