JAMA Psychiatry trial finds low-dose semaglutide cuts lab alcohol intake

A phase 2 clinical trial published in JAMA Psychiatry found that low-dose semaglutide reduced how much alcohol adults with alcohol use disorder (AUD) drank during a laboratory test, along with weekly craving scores, after nine weeks of treatment ^[1]. The drug is best known under the brand names Ozempic, Wegovy, and Rybelsus, but this study used it for a purpose the Food and Drug Administration has not approved, and at doses lower than those used for weight loss ^[1].

Researchers at a US academic medical center screened 504 potential participants between September 2022 and February 2024 and randomized 48 adults with AUD who were not seeking treatment for their drinking ^[1]. Of those, 34 (71%) were women, and the average age was 39.9 years ^[1]. Participants received either semaglutide or placebo on a weekly schedule that started at 0.25 mg for four weeks, increased to 0.5 mg for four weeks, and ended with a single 1.0 mg dose ^[1].

The main outcome was measured in a supervised laboratory setting where participants could drink alcohol after treatment. People on semaglutide consumed less alcohol, measured in estimated grams, with a medium-to-large effect size (β, -0.48; 95% CI, -0.85 to -0.11; P = .01), and had lower peak breath alcohol concentration (β, -0.46; 95% CI, -0.87 to -0.06; P = .03) compared with placebo ^[1].

Outside the lab, semaglutide did not change the average number of drinks per day or the number of drinking days overall. But it did reduce drinks consumed on drinking days (β, -0.41; 95% CI, -0.73 to -0.09; P = .04) and weekly alcohol craving scores (β, -0.39; 95% CI, -0.73 to -0.06; P = .01), and it predicted a greater drop in heavy drinking over time compared with placebo (β, 0.84; 95% CI, 0.71-0.99; P = .04) ^[1]. In a smaller subgroup of participants who smoked cigarettes, semaglutide was also linked to a steeper decline in cigarettes smoked per day relative to placebo (β, -0.10; 95% CI, -0.16 to -0.03; P = .005) ^[1].

The study's authors call these "initial" findings that justify larger clinical trials, not proof that semaglutide treats alcohol use disorder ^[1]. The trial is registered with ClinicalTrials.gov under the identifier NCT05520775 ^[1]. One study author disclosed consulting fees from Novo Nordisk, which makes semaglutide, along with research funding paid to their institution from Novo Nordisk and several other drug companies ^[1].

Why it matters for patients

This trial does not mean semaglutide is an approved or established treatment for alcohol use disorder. The study enrolled only 48 people at one site, and participants were not seeking help for their drinking, which may not reflect people who actively want treatment ^[1]. The doses tested were also lower than the 2.4 mg weekly dose used in Wegovy for weight management, so the results cannot be assumed to apply to standard prescribing ^[1].

The mixed results are also worth noting: semaglutide changed some drinking measures, like heavy drinking days and craving, but not others, like total drinking days ^[1]. That pattern suggests the drug's effects on alcohol use, if real, may be selective rather than sweeping. People currently using semaglutide or tirzepatide products for diabetes or weight management should not read this study as evidence that the drugs will change their drinking habits in a predictable way.

What happens next

The study authors say larger trials are needed to confirm these findings and determine whether GLP-1 receptor agonists like semaglutide have a real role in treating alcohol use disorder ^[1]. No specific timeline or follow-up trial name was given in the source material, so further clinical evidence is not yet available ^[1].