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Semaglutide and tirzepatide decrease cravings and reduce alcohol consumption

An analysis of social media posts and a remote study of individuals with obesity who reported using semaglutide and tirzepatide, has found that the drugs decreased cravings and reduced alcohol consumption, according to Virginia Tech researchers.

"These findings add to a growing literature that these medications may curb dangerous drinking habits," said Warren Bickel, Virginia Tech Carilion Behavioral Health Research Professor at the Fralin Biomedical Research Institute at VTC and corresponding author.

Scientists with the Fralin Biomedical Research Institute's Addiction Recovery Research Center combined two different studies to build on existing research, including studies that showed the drugs were effective in reducing alcohol consumption in animal models.

The first was an analysis of more than 68,000 Reddit posts from 2009–23 that included terms linked to GLP-1 approved medications. After cleaning the resulting data, the set was narrowed to 33,609 posts from 14,595 unique users. The study was unique in using Reddit to analyse the reported experience of thousands of users.

On examining alcohol-related discussions, researchers found that 962 individuals made 1,580 alcohol-related posts. Of those, 71.7% addressed reduced cravings, reduced usage and other negative effects due to drinking.

In a second study, 153 participants who self-reported having obesity were recruited from various social media platforms. Roughly a third of these participants represented the control group, a third were taking either a semaglutide injection or tablet, and a third were using tirzepatide.

Participants on semaglutide or tirzepatide reported drinking significantly fewer drinks, on average, than those in the control group who were not on any medication for diabetes or weight loss. In addition, researchers found that both the average number of drinks and the odds of binge drinking were found to be significantly lower.

Figure 1: The remote study provides strong converging evidence of reduced alcohol use. (A) Incidence Rate Ratio of Average drinks calculated from the past 30 days Timeline Follow Back. (B) Odds Ratio of binge drinking over the past 30 days (binomial distribution, 0; no binge, 1; binge) Males (> 5 drinks), Females (> 4 drinks). Comparison of (C) average drinks per episode of use (D) AUDIT scores (E) Sedative effects and (F) Stimulative effects of alcohol within and between groups. A significant reduction is seen both within (Before and after starting medications) and between (control vs. medication) groups for all four measures. Credit: Scientific Reports (2023). DOI: 10.1038/s41598-023-48267-2

Results also found that the stimulative and sedative effects of alcohol intoxication are reduced when taking these medications.

"Participants reported drinking less, experienced fewer effects of alcohol when they did drink it, and decreased odds of binge drinking," said Alexandra DiFeliceantonio, assistant professor at Fralin Biomedical Research Institute and one of the study's co-authors.

Researchers believe theirs is the first published report following tirezepatide, sold under the brand name Mounjaro, which was approved in 2022 and is used for treatment of type 2 diabetes and weight loss.

Case studies and reports in the popular press hint at the drugs' unexpected side effect of reducing addictive behaviours, including the desire to consume alcohol.

The FDA has only approved three medications to treat alcohol use disorder: disulfiram, naltrexone, and acamprosate. They have shown only modest success, have poor compliance and are under prescribed.

The authors suggest further randomised controlled trials to explore the therapeutic potential of GLP-1 agonists and GIP/GLP-1 combination drugs to treat alcohol use disorder, which affects 5.9% of individuals in the US ages 12 and older. In addition, the participants identified as mostly white and female, and further studies in more diverse populations are needed to examine sex and race differences.

"Although evidence supporting the use of these medications for alcohol use disorder is growing, the field still needs to learn considerably more about them, particularly in identifying the underlying mechanisms. We plan to contribute to that effort," added Bickel.

The findings, ‘Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity’, were reported in Scientific Reports.


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