From the Guidelines
No, GLP-1 (Glucagon-like peptide-1) and GLP-2 (Glucagon-like peptide-2) agonists are not currently FDA-approved for treating ethanol cravings or alcohol use disorder. While medications like semaglutide, liraglutide, and other GLP-1 agonists are approved for type 2 diabetes and weight management, they are not indicated for alcohol craving reduction. Currently, the FDA-approved medications for alcohol use disorder include naltrexone (oral 50mg daily or monthly injectable form), acamprosate (666mg three times daily), and disulfiram (250-500mg daily) 1. There is emerging research suggesting GLP-1 agonists might reduce alcohol consumption in preclinical models and small human studies by affecting reward pathways in the brain and reducing dopamine release associated with alcohol consumption. However, this remains investigational, and patients seeking treatment for alcohol cravings should use established medications with proven efficacy under medical supervision. Any off-label use of GLP-1 agonists for this purpose would be experimental and not supported by sufficient clinical evidence at this time.
Some key points to consider:
- GLP-1 receptor agonists have been shown to have high glucose-lowering efficacy, but with variation within the drug class 1.
- Semaglutide and liraglutide are FDA-approved for weight management, with semaglutide showing significant weight loss in clinical trials 1.
- GLP-1 agonists have been found to decrease the risk of cardiovascular events in adults with overweight or obesity without diabetes 1.
- However, there is limited evidence to support the use of GLP-1 agonists for treating ethanol cravings or alcohol use disorder, and they are not currently FDA-approved for this indication.
In terms of treatment options, the following medications are currently FDA-approved for alcohol use disorder:
- Naltrexone (oral 50mg daily or monthly injectable form)
- Acamprosate (666mg three times daily)
- Disulfiram (250-500mg daily) These medications have proven efficacy in reducing alcohol cravings and should be used under medical supervision. Any off-label use of GLP-1 agonists for this purpose would be experimental and not supported by sufficient clinical evidence at this time 1.
From the Research
GLP-1 and GLP-2 Agonists for ETOH Cravings
- There are studies that suggest GLP-1 agonists may be effective in reducing ethanol intake and cravings 2, 3, 4, 5, 6.
- GLP-1 agonists, such as liraglutide, semaglutide, and dulaglutide, have been shown to decrease ethanol intake in animal models 2, 3, 4.
- The exact mechanism of action is not fully understood, but it is thought that GLP-1 agonists may modulate the brain's reward system and reduce the reinforcing effects of ethanol 5.
- Clinical studies are limited, but one study found that a GLP-1 receptor agonist reduced alcohol intake in patients with type-2 diabetes mellitus 5.
- There is no direct evidence for the use of GLP-2 agonists in treating ETOH cravings.
- More research is needed to fully understand the potential of GLP-1 agonists as a treatment for alcohol use disorder and to determine their safety and efficacy in humans.
Current Approval Status
- GLP-1 agonists are currently approved for the treatment of type-2 diabetes and obesity, but not specifically for the treatment of alcohol use disorder or ETOH cravings 2, 3, 4.
- Further studies are needed to determine if GLP-1 agonists could be a viable treatment option for alcohol use disorder and to support their approval for this indication.