Wegovy/Semaglutide May Reduce Alcohol Dependence, Not Just Weight

A study out this week suggests that semaglutide—the active ingredient in popular obesity drug Wegovy—might be able to help people struggling with alcohol use disorder, too. In a small sample of cases, researchers found evidence that people who took semaglutide for weight loss also experienced a significant reduction in alcohol dependence symptoms. The team and other scientists have begun to conduct clinical trials to further explore this link.

Semaglutide is a synthetic and longer-lasting version of glucagon-like peptide 1 (GLP-1), a hormone that helps regulate our insulin production and appetite, among other things. Developed by Novo Nordisk, it was first approved to manage type 2 diabetes in 2017 under the brand name Ozempic and later approved as the higher-dose formulation Wegovy in 2021 for obesity. Newer GLP-1s like semaglutide and similar drugs have proven to be much more effective at helping people lose weight than diet and exercise alone or past obesity medications (in clinical trials of Wegovy, people have lost around 15% of their baseline weight).

While the primary cells that produce and respond to GLP-1 are found in the gut, there are also GLP-1 related cells in the brain. It’s thought that these drugs work to tamp down appetite not only by physically affecting the digestive tract, such as by slowing digestion, but by interacting with these brain cells as well. And that’s led to speculation that these drugs could reduce people’s cravings for things besides food.

Studies have found that semaglutide can lead to reduced alcohol and drug consumption in lab animals, for instance. And in the wake of the rapid rise in popularity for these drugs, there have been anecdotal reports of people drinking or gambling less often after they began to take semaglutide. But this new study, published Monday in the Journal of Clinical Psychiatry, seems one of the first to formally document some of these reports.

The authors tracked down six cases of patients who were prescribed semaglutide for weight loss but were also previously diagnosed with alcohol use disorder, defined as an inability to control their drinking despite harmful consequences for themselves or others. All of the patients seemed to experience a clear reduction in their alcohol-related symptoms, the team found, even those who didn’t lose much weight while taking semaglutide.

“This case series is consistent with preclinical data and suggests that GLP-1RAs have strong potential in the treatment of [alcohol use disorder],” the study authors wrote.

The researchers are from the University of Oklahoma School of Community Medicine and the Oklahoma State University Center for Health Sciences. Some of them have already started to recruit patients with alcohol use disorder for a randomized clinical trial of semaglutide, while the National Institute on Drug Abuse is funding and conducting its own sister trial.

Novo Nordisk would have to apply for regulatory approval of any new indication of semaglutide, including alcohol use disorder. And it’s not certain that current and future trials, even with positive data, would lead to the drug officially becoming a treatment for the condition. But there are only three formally approved medications for alcohol use disorder currently, which all seem to have modest effectiveness at best. So even showing that semaglutide and other GLP-1s can be an effective, if off-label, option for these patients would still be worthwhile.

“This research marks a significant step forward in our understanding of the potential therapeutic applications of semaglutide in the field of addiction medicine,” said lead author Jesse Richards, director of Obesity Medicine and assistant professor of Medicine at OU-TU School of Community Medicine, in a statement from the university.