In the graphs, the changes in weight are much more impressive than the changes in alcohol
The weight-loss drug that curbs appetite may also curb the urge to drink
STUDY: Hendershot CS et al, JAMA Psychiatry 2025;82(4):395–405
STUDY TYPE: Randomized, double-blind, placebo-controlled trial
FUNDING: National Institute on Alcohol Abuse and Alcoholism
Background
There’s a lot of hope that GLP-1 receptor agonists like semaglutide (Ozempic) will reduce addictions, and this is the first trial to test that against placebo. It is a phase II trial, suggesting the industry may have interest in conducting larger trials toward FDA approval.
The Study
Forty-eight non-treatment-seeking adults with alcohol use disorder were randomized to weekly subcutaneous semaglutide (titrated from 0.25 mg to 0.5 mg over 8 weeks) or placebo. The primary outcome was objective alcohol self-administration in a laboratory setting. This matters, as there are two levels of artificiality here: The patients are not treatment-seeking, and the outcome was in a lab.
Semaglutide reduced laboratory alcohol consumption with medium-to-large effect sizes for grams consumed (0.48) and peak breath alcohol concentration (0.46). In real-world weekly data (outside the lab), it also significantly cut drinks per drinking day and craving, and reduced heavy drinking days over time — with effect sizes reaching the large range (Cohen’s d > 0.80) at the 0.5 mg dose. Total drinking days didn’t change, suggesting the drug reduced quantity more than frequency.
In the small subset of smokers, cigarettes per day also declined. Adverse effects were mild; no serious events or treatment discontinuations occurred.
Practice Implications
- The optimistic view: Semaglutide works, and this confirms it, with positive results on the primary measure
- The skeptical view: It barely worked in an artificial setting, with only 3/5 real-world outcomes positive. Lots of treatments succeed in non-treatment seeking populations with substance use disorders that then fail in the real world.
— Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
