Study links semaglutide and tirzepatide to lower self-reported drinking

A study published Nov. 28, 2023 in the journal Scientific Reports reported that people taking semaglutide or tirzepatide drank less alcohol than they did before starting the drugs, and less than a comparison group taking neither medication ^[1]. The authors called it the first published report of reduced drinking with tirzepatide specifically.

Semaglutide (sold as Ozempic, Wegovy and Rybelsus) is a GLP-1 agonist, and tirzepatide (sold as Mounjaro and Zepbound) is a GLP-1/GIP combination. Both are FDA-approved for managing type 2 diabetes and obesity ^[1].

The paper described two separate studies. The first used machine learning to map about 68,250 Reddit posts about GLP-1 or GLP-1/GIP agonists. It sorted the posts into eight major themes, including effects of the medications (30% of posts), diabetes (21%) and weight loss and obesity (19%). Among the 1,580 posts that mentioned alcohol, 71% were classified as describing craving reduction, a decreased desire to drink or other negative effects of drinking ^[1].

The second study recruited 153 adults who currently drank alcohol and had a body mass index of 30 or higher. Participants reported either taking semaglutide or tirzepatide for at least 30 days, or taking no medication for diabetes or weight loss, which served as the control group ^[1].

Compared with their own reports from before they started medication and with the control group, the medication group reported significantly lower alcohol intake, fewer drinks per drinking episode, lower odds of binge drinking, lower scores on the Alcohol Use Disorders Identification Test (AUDIT), and lower stimulating and sedative effects ^[1]. The authors summarized the findings as "initial real-world evidence" and suggested potential efficacy for treating alcohol use disorder in people who also have obesity ^[1].

The study has limits that the paper itself frames. Participants reported their own medication use and drinking rather than being randomly assigned to a drug or a placebo, so the design cannot show that the medications caused the difference in drinking ^[1]. The authors also noted that no research had previously examined tirzepatide and alcohol consumption, and that the report is early evidence rather than a test of whether these drugs treat alcohol use disorder ^[1].

Why it matters for patients

Alcohol use disorder remains one of the most undertreated conditions, and the only FDA-approved medications for it — disulfiram, naltrexone and acamprosate — have had modest success. Naltrexone, for example, reduces relapse rates by about 5%, and about two-thirds of patients relapse within the first year of abstinence-based treatment ^[1].

For someone already taking semaglutide or tirzepatide for diabetes or weight loss, this study raises a practical question about whether their drinking habits might change. It does not answer that question for any individual, and neither drug is approved to treat alcohol use disorder ^[1].

Only one clinical trial has tested a GLP-1 agonist, exenatide, in people seeking treatment for alcohol use disorder. That trial did not significantly reduce days of heavy drinking overall, although brain imaging showed reduced activity in reward-related brain regions when participants viewed alcohol images, and participants with obesity in the treatment group had a substantial reduction in heavy drinking. Participants with a BMI below 25 in the placebo group also reduced heavy drinking days ^[1].

Whether semaglutide or tirzepatide reduces drinking in a randomized, controlled trial has not been reported. It is also not yet known whether any reduction in drinking persists over the long term, whether it applies to people without obesity, or how the effect compares with approved alcohol use disorder medications ^[1].