Sunday, October 16, 2022

'Wonder' drug that causes massive weight loss could also suppress the desire for alcohol

Good news! Almost too good to be true! The positive effect on alcohol consumption has not yet been verified by clinical trials.

"Semaglutide, sold under the brand names Wegovy and Ozempic, is an injectable drug originally meant to help patients manage diabetes. Since 2021, the drug has been approved by the FDA in the United States for weight loss after studies found obese patients could lose 15% to 20% of their body weight over 68 weeks. But as the drug became increasingly popular, more and more patients and their doctors have noticed that it wasn’t just their calorie intake that plummeted — it was their [alcohol] drinking too. ...
Semaglutide is a synthetic version of the human GLP-1 (glucagon-like protein), which increases the release of insulin when blood sugar is elevated, delays gastric emptying, and reduces appetite. Semaglutide is typically prescribed against type 2 diabetes, but since a known side effect is weight loss many doctors are now also prescribing it off-label for weight loss in those without diabetes. ...
The synthetic version of GLP-1 has been modified so that it is less likely to be broken down and therefore has a longer duration of action. It comes in the form of two different disposable single-use pens in either 0.25mg increments or 1mg increments. The patient can easily self-administer their own injection, typically once a week. ...
However, the study did find that “dopamine transporter availability was lower in the exenatide group compared with the placebo group,” suggesting GLP-1 analogs hijack the brain’s reward pathway. ...
It could be that semaglutide, liraglutide, exenatide, and other glucagon-like proteins have the best suppression of alcohol cravings in more casual drinkers [as opposed to heavy drinkers] ..."

From the abstract:
"Background.
Alcohol use disorder (AUD) is a chronic, relapsing brain disorder that accounts for 5% of deaths annually, and there is an urgent need to develop new targets for therapeutic intervention. The glucagon-like peptide-1 (GLP-1) receptor agonist exenatide reduces alcohol consumption in rodents and nonhuman primates, but its efficacy in patients with AUD is unknown.
Methods.
In a randomized, double-blinded, placebo-controlled clinical trial, treatment-seeking AUD patients were assigned to receive exenatide (2 mg subcutaneously) or placebo once weekly for 26 weeks, in addition to standard cognitive-behavioral therapy. The primary outcome was reduction in number of heavy drinking days. ...
Results.
A total of 127 patients were enrolled. Our data revealed that although exenatide did not significantly reduce the number of heavy drinking days compared with placebo, it significantly attenuated fMRI alcohol cue reactivity in the ventral striatum and septal area, which are crucial brain areas for drug reward and addiction. In addition, dopamine transporter availability was lower in the exenatide group compared with the placebo group. Exploratory analyses revealed that exenatide significantly reduced heavy drinking days and total alcohol intake in a subgroup of obese patients (BMI > 30 kg/m2). Adverse events were mainly gastrointestinal.
Conclusion.
This randomized controlled trial on the effects of a GLP-1 receptor agonist in AUD patients provides new important knowledge on the effects of GLP-1 receptor agonists as a novel treatment target in addiction."

'Wonder' drug that causes massive weight loss could also suppress the desire for alcohol. Doctors are now eyeing it for treating addiction It's a double punch combo that seems very promising.




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