A RANDOMISED clinical trial has found that low-dose semaglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, reduces alcohol craving and some measures of alcohol consumption in adults with alcohol use disorder (AUD), supporting the need for larger trials to explore its potential as a treatment.
Alcohol use disorder is a chronic condition characterised by excessive alcohol consumption and cravings, often leading to significant health and social consequences. Preclinical and observational studies have suggested that GLP-1 receptor agonists, commonly used for weight loss and diabetes management, may also reduce alcohol intake. This phase 2 double-blind trial aimed to evaluate the effects of once-weekly subcutaneous semaglutide on alcohol consumption and craving in adults with AUD.
The trial enrolled 48 non-treatment-seeking participants with AUD, 71% of whom were female, with a mean age of 39.9 years. Participants were randomly assigned to receive either semaglutide (0.25 mg/week for 4 weeks, 0.5 mg/week for 4 weeks, and 1.0 mg for 1 week) or placebo over nine weeks of outpatient treatment. The primary outcome was laboratory-measured alcohol self-administration before and after treatment, while secondary outcomes included changes in weekly alcohol consumption and craving.
Semaglutide significantly reduced posttreatment alcohol consumption during the laboratory task, with medium to large effect sizes for grams of alcohol consumed (β = −0.48; P = .01) and peak breath alcohol concentration (β = −0.46; P = .03). While it did not affect average daily drinks or the number of drinking days, semaglutide significantly reduced drinks per drinking day (β = −0.41; P = .04) and weekly alcohol craving (β = −0.39; P = .01). It also predicted greater reductions in heavy drinking over time compared to placebo (β = 0.84; P = .04). Additionally, in participants who smoked cigarettes, semaglutide was associated with a significant reduction in cigarettes per day (β = −0.10; P = .005).
These findings suggest that semaglutide could be a promising treatment for AUD by reducing cravings and certain drinking behaviours. For clinical practice, this raises the possibility of repurposing GLP-1 receptor agonists for addiction management. Larger trials are needed to confirm these results and explore the long-term efficacy and safety of semaglutide in this context.
Katrina Thornber, EMJ
Reference
Hendershot CS et al. Once-weekly semaglutide in adults with alcohol use disorder: a randomized clinical trial. JAMA Psychiatry. 2025;DOI:10.1001/jamapsychiatry.2024.4789.
