GLP-1s Could Help Reduce Alcohol Addiction, Study Finds

The use of semaglutide and liraglutide was linked to a significantly lower risk of alcohol use disorder (AUD)-related hospitalizations, suggesting that these medications may offer promise as part of AUD treatment, particularly in patients with comorbid obesity or type 2 diabetes.¹

Preliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption. | Image credit: BillionPhotos.com - stock.adobe.com

The Swedish nationwide cohort study is published in JAMA Psychiatry.

“In this nationwide register-based study, the GLP-1 agonists semaglutide and liraglutide, but not other GLP-1 agonists, were associated with a markedly reduced risk of AUD- and SUD [substance use disorder]-related hospitalizations as well as somatic hospitalizations,” wrote the researchers of the study.

Just over 28 million people 12 years and older in the US have had AUD in the past year, according to the 2023 National Survey on Drug Use and Health (NSDUH).² This includes 757,000 adolescents aged 12 to 17 years with AUD.

The study utilized Swedish nationwide electronic registries, including inpatient and specialized outpatient visits, as well as sickness absence and disability pension diagnoses to identify individuals aged 16 to 65 years with an AUD between 2006 and 2021.¹

A cohort of 227,886 individuals was followed from AUD diagnosis until death, emigration, or the study's end date, December 31, 2023. The primary exposure was the use of GLP-1 agonists, including exenatide, liraglutide, dulaglutide, and semaglutide (with lixisenatide excluded due to limited use), and the secondary exposure was the use of AUD medications (disulfiram, acamprosate, and naltrexone, with nalmefene excluded for similar reasons).

The main outcome was hospitalization due to AUD, with secondary outcomes including SUD-related hospitalizations, somatic hospitalizations, and suicide attempts.

A total of 133,210 individuals were hospitalized for AUD, and 138,390 were hospitalized for SUD. Use of semaglutide was associated with the lowest risk for both AUD and SUD-related hospitalizations (adjusted hazard ratios [aHR], 0.64 and 0.68, respectively), while liraglutide showed the second lowest risk (aHR, 0.72 for AUD and 0.78 for SUD). In contrast, the use of AUD medications in general did not significantly alter the risk of hospitalization for AUD or SUD (aHR 0.98).

Regarding somatic hospitalizations, semaglutide was associated with the lowest risk (aHR, 0.78) and liraglutide with the second lowest (aHR, 0.79), while the use of AUD medications was linked to a modest reduction in somatic hospitalizations (aHR, 0.85). Although semaglutide use did not significantly affect the risk of suicide attempts (aHR, 0.55), the use of AUD medications was associated with an increased risk of suicide attempts (aHR, 1.15).

However, the researchers noted that this study was an observational study and, therefore, can only address associations and not causality.

Overall, the researchers believe the study supports the use of some GLP-1 medications to curb alcohol addiction.

“AUDs and SUDs are undertreated pharmacologically, despite the availability of effective treatments,” wrote the researchers. “However, novel treatments are also needed because existing treatments may not be suitable for all patients. GLP-1 agonists, and especially semaglutide and liraglutide, may be effective in the treatment of AUD. Randomized clinical trials are urgently needed to confirm whether GLP-1 agonists could be used to treat AUD and SUDs.”

References

1. Lähteenvuo M, Tiihonen J, Solismaa A, et al. Repurposing semaglutide and liraglutide for alcohol use disorder. JAMA Psychiatry. Published online November 13, 2024. doi:10.1001/jamapsychiatry.2024.3599

2. Alcohol use disorder (AUD) in the United States: age groups and demographic characteristics. NIH. Accessed November 13, 2024. https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-use-disorder-aud-united-states-age-groups-and-demographic-characteristics.