A randomized clinical trial conducted by scientists from the University of Colorado Anschutz Medical Campus suggests that oral semaglutide has the potential to help individuals with Alcohol Use Disorder (AUD) decrease episodes of excessive alcohol consumption. The findings were published in the American Journal of Psychiatry and involved adults seeking treatment for this condition.
The study followed 50 participants with moderate or severe alcohol use disorder over eight weeks. Although the medication did not meet its primary endpoint, which was the reduction of alcohol craving measured in the lab, researchers noted improvements in several indicators of consumption and consequences related to alcoholism, strengthening the prospect of semaglutide as a future therapeutic alternative.
How the study was conducted
Researchers divided the 50 volunteers into two groups: one received oral semaglutide and the other received a placebo; the study was double-blind, meaning neither the patients nor the researchers knew who belonged to which group. The treatment lasted for eight weeks. During the first four weeks, volunteers took a daily dose of 3 mg of semaglutide, and in the subsequent four weeks, the dose was increased to 7 mg daily.
All participants had a Body Mass Index (BMI) of 25 or higher, presented with moderate or severe alcohol use disorder, and were seeking help to reduce or cease alcohol consumption. Before the investigation began, these participants consumed an average of about six alcoholic drinks per day and reported approximately five days of excessive consumption weekly. Additionally, 98% of them were classified by the World Health Organization (WHO) as being at high or very high risk for alcohol consumption.
Reduction in excessive alcohol consumption
By the end of the eight weeks, participants who used semaglutide demonstrated fewer days of excessive alcohol consumption, consumed smaller amounts of drinks per occasion, and showed a decrease in daily alcohol craving compared to the placebo group. The treatment was also linked to a reduction in alcohol-related problems and a drop in cannabis use days among those already using the substance.
Joseph P. Schacht, an associate professor at the University of Colorado Anschutz School of Medicine and lead author of the study, commented to Newsweek that the results suggest the drug may be beneficial for people who have not responded well to current therapies. Schacht stated: 'This study suggests that oral semaglutide can help reduce heavy and harmful alcohol consumption, even in people who are not trying to stop drinking completely.'
Despite the positive results, the study's main objective—measuring the intensity of the urge to drink after exposure to alcohol-related stimuli in a controlled environment—did not show a statistically significant difference between the groups. Similarly, the reduction in the average daily doses consumed throughout the study did not reach statistical significance.
Weight loss did not explain the results
Semaglutide, known for its use in treating obesity and type 2 diabetes, is generally associated with weight loss. However, in this specific study, this phenomenon did not occur. Researchers found no significant difference in weight loss between the groups, indicating that the reduction in alcohol consumption appears to have happened independently of changes in body weight or dietary habits.
According to the authors, this finding supports the hypothesis that the drug may be acting on brain mechanisms related to reward and alcohol craving, rather than merely through appetite suppression.
Results still need confirmation
The side effects recorded during the research were mostly mild and occurred with similar frequency in both groups. Only one participant had to discontinue treatment after developing a skin rash considered likely related to the medication. Treatment adherence remained high.
However, the researchers themselves emphasize that the results must be analyzed with caution. The study was limited to 50 participants, was conducted at a single research center, and included predominantly white individuals with overweight or obesity. For this reason, the authors advocate for larger and more extensive clinical trials to verify if the observed benefits persist in more diverse populations.
Alcohol use disorder currently has only three medications approved by the Food and Drug Administration (FDA) for treatment, and no new therapy had been approved for this purpose since 2006. Given this scenario, researchers view semaglutide as a promising candidate for future clinical investigations.
