GLP-1 medications may have potential in treating addictions, new research shows

Drugs from the GLP-1 receptor agonist group, which are widely used in the treatment of type 2 diabetes and obesity, may also have potential in addiction therapy. This is shown by a new meta-analysis by scientists from Washington University School of Medicine in St. Louis, published in the BMJ, Pharmaphorum reports.

The study covers data from over 600,000 American veterans with type 2 diabetes. Participants treated with GLP-1 agonists were compared with patients taking another commonly used class of diabetes medications – SGLT2 inhibitors.

After three years of follow-up, researchers found that patients taking GLP-1 medications such as semaglutide and tirzepatide had approximately a 14% lower risk of developing substance use disorders. The reduction was observed across all major addictions, including alcohol, opioids, cocaine, cannabis, and nicotine.

In patients who already had an addiction at the start of the observation, a significant reduction in severe complications was also reported. Emergency department visits related to addictions dropped by about one-third. Hospitalizations and cases of suicidal ideation or attempts decreased by about one-quarter, and overdose cases by 39%. The overall risk of addiction-related death was approximately half as low.

According to the study’s lead author, Ziyad Al-Aly, these drugs may act on a common biological mechanism of addiction. In his words, most existing therapies target a specific substance, while GLP-1 medications likely affect the very sensation of craving that underlies various addictions.

The potential of this class of drugs is already being actively investigated. Eli Lilly, for example, is testing its new candidate brenipatide in Phase III for alcohol dependence and in Phase II for nicotine dependence. A Phase II study with semaglutide also shows promising results in the treatment of alcohol dependence.

The authors emphasize that the analysis has limitations. Most participants were older men. Factors such as the severity of addiction, socioeconomic status, or lifestyle could also influence the results.

In parallel, another meta-study published in the journal The Lancet eClinicalMedicine by scientists from the University of Cambridge shows that after discontinuing GLP-1 agonist therapy, patients typically regain some of the lost weight. On average, about 60% of the lost weight returns within one year, after which the weight stabilizes at a new, lower level.

However, researchers note that it remains unclear whether the regained weight is primarily fat tissue or includes muscle mass, which could be significant for long-term health effects.