Improvement of cardiovascular health and depressive symptoms, protective effect on the brain, benefit against kidney failure and even against HIV… In September 2024, Science and Future has taken stock of the prolific research on GLP-1 analogues. Currently indicated in diabetes and certain cases of obesity, these molecules could see their range of prescriptions expand. If the improvement of vascular health is the most solid lead, other effects continue to be explored and are gradually being confirmed. Recently, this is the case for the benefits on alcohol dependence. As an indication, it is estimated that alcohol is the cause of 49,000 deaths per year in France.
As early as preclinical studies in the 2010s, scientists have observed that GLP-1 can defuse addictive behaviors. But until now, work on humans has been retrospective: researchers examine the files of patients who have been prescribed GLP-1 analogues to treat diabetes, for example, and observe the evolution of a behavior, such as addiction.This time, scientists at the University of Southern California are taking a step forward with a randomized controlled trial," says Nicolas Marie, a researcher at the CNRS. The subject of the study is alcohol addiction, and the molecule was administered to analyze its effects on this behavior and not on obesity or diabetes. In other words, the addiction is observed in itself and not as a side effect. Their results were published in the journal JAMA Psychiatry.
A decrease in craving and alcohol consumption
Semaglutide was the subject of a large-scale retrospective study in May 2024. It explored the effects of this molecule on alcohol dependence. The analysis of the medical records of 80,000 obese people revealed a halving of their consumption. This time, researchers brought together a small cohort of around fifty adults suffering from moderate alcohol consumption disorders who were not actively seeking treatment.
“ In the previous month, participants had consumed more than 7 drinks per week for women, and more than 14 for men. They had also experienced two or more episodes of heavy drinking (more than 4 or 5 drinks depending on gender),” the study authors said. They were then divided into two groups, some received weekly injections of a standard dose of Ozempic, while others received a placebo.
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After nine weeks, the researchers recorded their alcohol consumption, notably by measuring the concentration of alcohol in their breath. Result: semaglutide significantly reduced participants' consumption and alcohol "cravings", i.e. irrepressible desires. Nicolas Marie reports. Among other things, nearly 40% of people treated with Ozempic reported no days of heavy alcohol consumption during the last month of treatment, compared to 20% in the placebo group.
GLP-1 acts directly on the reward system
“There are still few solutions for treating alcohol addiction, and this work confirms the trend observed in retrospective studies: semaglutide could be added to the therapeutic arsenal for this addiction if new studies continue to support these results,” Nicolas Marie rejoices. If this molecule can have an effect on addictions, it is because GLP-1 acts largely in the brain, in particular on the reward circuit. "There are GLP-1 receptors all over the body, including the nucleus accumbens, which is responsible for the individual's state of satisfaction," ", the researcher emphasizes. GLP-1 thus inhibits compulsion and the search for reward. According to the authors of the study, semaglutide would be at least as effective as naltrexone, currently prescribed to combat alcohol addiction.
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For Nicolas Marie, semaglutide is not about to revolutionize the treatment of alcohol dependence, but would be added to the still limited therapeutic options. Addictive disorders are difficult to treat because the effectiveness of treatments varies widely from one individual to another. But if these results are confirmed through a study on a larger and more diverse cohort, GLP-1 analogues will open a new avenue, thus increasing the chances of finding an appropriate treatment for these patients," he concludes.
Especially since this latest study shows benefits with a classic dosage. The researchers add that smokers who were part of the Ozempic group also reduced their cigarette consumption. New studies are expected to continue exploring the effects of these molecules on addictions and depression in particular.
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