The First RCT to Suggest Semaglutide Curbs Drinking

Early on after semaglutide captured public attention, people started noticing that the drug was not only helping people reduce excessive weight, it seemed to reduce the desire for drinking alcohol. But until now, all we’ve had to support this idea were anecdotes and retrospective observational studies. Yesterday, JAMA Psychiatry published an RCT offering stronger evidence that semaglutide curbs drinking.

A Small Study, Low Doses

Let’s be clear, this is not the final word. It was a small study of 48 persons with alcohol use disorder. The dose of semaglutide was relatively low – no more than one milligram for a week. In nine weeks of treatment, people received either placebo or a gradual escalation from 0.25 mg per week to 0.5 mg and finally to 1.0 mg for the final week of the study. This is less than half of the 2.4 mg weekly dose used in obesity. And it was a very short duration of dosing.

Nonetheless, Christian Hendershot and colleagues found a significant reduction in alcohol use in some but not all measures of weekly alcohol consumption. They also found a reduction in weekly alcohol craving. And then finally, they found a bonus effect – less cigarette use among the subset of persons who smoke.

Curb Your Enthusiasm

Kyle Simmons is the senior author on this paper and is conducting another, longer trial of semaglutide for alcohol use disorder. He advises caution for now:

“No one drug works for everybody. I’m optimistic, don’t get me wrong, But I just don’t feel comfortable saying that patients should seek out these medications for addiction yet.”

This caution is consistent with observations from a recent study of persons receiving GLP-1 agonists in a telehealth weight management clinic. Slightly less than half (45%) of the subjects who reported drinking when they began treatment reported that they drank less during treatment. Slightly more than half (52%) reported no change in their drinking. Only 2% reported an increase.

So, while the latest RCT suggests semaglutide curbs drinking in at least some of people who use it, there’s still much to learn. It may prove to be useful for treating alcohol use disorder. But just how useful it will be is very much an open question.

Click here for the study in JAMA Psychiatry and here for the telehealth study in JAMA Network Open. For further perspective, click here, here, and here.

A Good Drink, painting by Eduard von Grützner / WikiArt

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February 13, 2025