The Weekly Mind Reader: Semaglutide In Alcohol Use Disorder Treatment

by Staff Writer
December 1, 2023 at 9:05 AM UTC

This week, we explore a case on hallucinations, the link between concussions and mental health, and new insights into suicide.

Experts already consider semaglutide a breakthrough drug in obesity treatment. In clinical trials it has led to an average weight loss of about 15 percent, making it one of the most effective weight management treatments ever. 

A recent review published in The Journal of Clinical Psychiatry investigated another potential use for semaglutide: mitigating the negative symptoms of alcohol use disorder (AUD). The study presented a case series of six patients whose condition improved after receiving semaglutide treatment.

Alcohol use disorder is a significant global health issue. According to the World Health Organization, it contributes to more than three million preventable deaths yearly. However, FDA-approved medications for its treatment are still few and far between. Semaglutide belongs to a class of drugs called glucagon-like peptide-1 receptor agonists, or GLP-1RAs, which have shown some success in preclinical studies for reducing alcohol consumption.

The case series in this paper included a retrospective chart review where researchers treated patients with semaglutide for weight loss, who also tested positive for AUD. Researchers used the Alcohol Use Disorder Identification Test (AUDIT) to assess AUD symptoms, considering a score above 8 as positive. All six patients in the case series met these criteria.

Complete Success

Prescribing between .25 and .5 mg of semaglutide weekly led to a significant reduction in AUD symptoms for every patient. Researchers measured their improvement by comparing AUDIT scores before and after initiating semaglutide therapy.On average, patients decreased 9.5 points in AUDIT scores, indicating substantial improvement in AUD symptomatology. 

These findings are consistent with previous preclinical data that suggests the potential of GLP-1RAs in treating AUD. They don’t provide definitive evidence for using semaglutide to manage AUD, but do suggest the potential for further randomized, placebo-controlled clinical studies to establish its efficacy.

It adds to a growing body of research exploring alternative treatments for AUD and highlights the potential of repurposing existing medications for this purpose. 

“This research marks a significant step forward in our understanding of the potential therapeutic applications of semaglutide in the field of addiction medicine,” said the lead author, Jesse Richards, MD, the director of Obesity Medicine and assistant professor of Medicine at OU-TU School of Community Medicine.

Kyle Simmons, the paper’s senior author and professor of Pharmacology & Physiology at OSU-Center for Health Sciences noted that this case series evidence paves the way for gold-standard placebo-controlled clinical trials such as the one he is currently conducting in Tulsa at the OSU Hardesty Center for Clinical Research and Neuroscience. He added, “With the publication of this case series in The Journal of Clinical Psychiatry, the stage is set for future clinical trials, such as the STAR [Semaglutide Therapy for Alcohol Reduction] studies, which can definitively tell us whether semaglutide is safe and effective for treatment of alcohol use disorder.”

The authors emphasized actively discouraging patients from self-medicating with semaglutide to control alcohol consumption without medical supervision. They also highlighted the necessity for knowledgeable healthcare professionals to monitor the drug’s use.

IN OTHER PSYCHIATRY AND NEUROLOGY NEWS

  • A case vignette and discussion should prove useful for clinicians who use monoclonal antibodies in the management of mild cognitive impairment and early Alzheimer’s disease. 
  • After eating noodles cooked in vinegar, a patient on disulfiram treatment developed erythematous plaques and papules. Here’s how doctors managed his treatment.
  • The first proof that social media images can be leveraged to predict validated suicide risk.
  • The case of an inmate who was diagnosed with schizophrenia about a year after he experienced an extended period of time in solitary confinement while in prison.  
  • A recent report proposes a chemical explanation for the dreaded red wine headache.
  • Join The Journal of Clinical Psychiatry on Facebook and Instagram

NEW AT CME INSTITUTE

Click to earn free accredited CME credit.

Optimizing Mental Health for Women: Recognizing and Treating Mood Disorders Throughout the Lifespan

Reviewing Non-Dopaminergic Mechanisms for Positive and Negative Schizophrenia Symptom Management

Untangling the Complexity of Alzheimer Disease With Effective Diagnostic Tools and Novel Treatment Options

Commentary

Substance Use Disorder Treatment Programs for Transgender and Gender Diverse Patients

The authors discuss responsiveness of transgender and gender diverse patients to SUD treatment at different care levels (eg, outpatient, residential, inpatient), as well as how to reduce stressors and make treatment programs more inclusive.

Anshul V. Puli and others

Case Report

Cisplatin-Etoposide–Induced Hyperammonemic Encephalopathy in a Lung Cancer Patient

A 68-year-old cancer patient experienced delirium during the third cycle of treatment with cisplatin-etoposide.

Tanvi Mittal and others