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Cited by 136Substance Abuse Treatment and OutcomesDiabetes Treatment and ManagementAlcohol Consumption and Health Effects

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Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder

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Lähteenvuo, Markku, Tiihonen, Jari, Solismaa, Anssi, Tanskanen, Antti, Mittendorfer-Rutz, Ellenor, Taipale, Heidi·2025·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2024.3599PMC PMC11561716
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Abstract

Importance: Preliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption. Objective: To test whether the risk of hospitalization due to alcohol use disorder (AUD) is decreased during the use of GLP-1 agonists compared with periods of nonuse for the same individual. Design, Setting, and Participants: This cohort study was an observational study conducted nationwide in Sweden using data from January 2006 to December 2023. The population-based cohort was identified from registers of inpatient care, specialized outpatient care, sickness absence, and disability pension. Participants were all residents aged 16 to 64 years who had a diagnosis of AUD. Exposures: The primary exposure was use of individual GLP-1 agonists (compared with nonuse of GLP-1 agonists), and the secondary exposure was medications with indication for AUD. Main Outcomes and Measures: The primary outcome was AUD hospitalization analyzed in a Cox regression within-individual model. Secondary outcomes were any substance use disorder (SUD)–related hospitalization, somatic hospitalization, and suicide attempt. Results: The cohort included 227 866 individuals with AUD; 144 714 (63.5%) were male and 83 154 (36.5%) were female, with a mean (SD) age of 40.0 (15.7) years. Median (IQR) follow-up time was 8.8 (4.0-13.3) years. A total of 133 210 individuals (58.5%) experienced AUD hospitalization. Semaglutide (4321 users) was associated with the lowest risk (AUD: adjusted hazard ratio [aHR], 0.64; 95% CI, 0.50-0.83; any SUD: aHR, 0.68; 95% CI, 0.54-0.85) and use of liraglutide (2509 users) with the second lowest risk (AUD: aHR, 0.72; 95% CI, 0.57-0.92; any SUD: aHR, 0.78; 95% CI, 0.64-0.97) of both AUD and SUD hospitalization. Use of any AUD medication was associated with a modestly decreased risk (aHR, 0.98; 95% CI, 0.96-1.00). Semaglutide (aHR, 0.78; 95% CI, 0.68-0.90) and liraglutide (aHR, 0.79; 95% CI, 0.69-0.91) use were also associated with decreased risk of somatic hospitalizations but not associated with suicide attempts (semaglutide: aHR, 0.55; 95% CI, 0.23-1.30; liraglutide: aHR, 1.08; 95% CI, 0.55-2.15). Conclusions and Relevance: Among patients with AUD and comorbid obesity/type 2 diabetes, the use of semaglutide and liraglutide were associated with a substantially decreased risk of hospitalization due to AUD. This risk was lower than that of officially approved AUD medications. Semaglutide and liraglutide may be effective in the treatment of AUD, and clinical trials are urgently needed to confirm these findings.

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Figure 1. Risk of Hospitalization Due to Alcohol Use Disorder (AUD) and Substance Use Disorder (SUD) The use of individual glucagon-like peptide-1 receptor (GLP-1) agonists was compared with nonuse of GLP-1 agonists. Groupwise and use of specific AUD medications were compared with nonuse of AUD medications. Both of these models (A and B) were adjusted for time-varying use of psychotropic medications (antipsychotics, N05A; antidepressants, N06A; mood stabilizers, including carbamazepine, N03AF01; valproic acid, N03AG01; lamotrigine, N03AX09; and lithium, N05AN01), benzodiazepines and related drugs (N05BA, N05CD, N05CF), and attention-deficit/hyperactivity disorder (ADHD) medications (N06BA); use of antidiabetic drugs other than GLP-1 agonists (A10 excluding A10BJ); temporal order of GLP-1 medication; and time since cohort entry. aHR indicates adjusted hazard ratio.
Figure 1. Risk of Hospitalization Due to Alcohol Use Disorder (AUD) and Substance Use Disorder (SUD) The use of individual glucagon-like peptide-1 receptor (GLP-1) agonists was compared with nonuse of GLP-1 agonists. Groupwise and use of specific AUD medications were compared with nonuse of AUD medications. Both of these models (A and B) were adjusted for time-varying use of psychotropic medications (antipsychotics, N05A; antidepressants, N06A; mood stabilizers, including carbamazepine, N03AF01; valproic acid, N03AG01; lamotrigine, N03AX09; and lithium, N05AN01), benzodiazepines and related drugs (N05BA, N05CD, N05CF), and attention-deficit/hyperactivity disorder (ADHD) medications (N06BA); use of antidiabetic drugs other than GLP-1 agonists (A10 excluding A10BJ); temporal order of GLP-1 medication; and time since cohort entry. aHR indicates adjusted hazard ratio.CC BY · PubMed Central
Figure 2. Risk of Hospitalization Due to Somatic Reasons and Suicide Attempt The use of individual glucagon-like peptide-1 receptor (GLP-1) agonists was compared with nonuse of GLP-1 agonists. Groupwise and use of specific alcohol use disorder (AUD) medications were compared with nonuse of AUD medications. Both of these models (A and B) were adjusted for time-varying use of psychotropic medications (antipsychotics, N05A; antidepressants, N06A; mood stabilizers, including carbamazepine, N03AF01; valproic acid, N03AG01; lamotrigine, N03AX09; and lithium, N05AN01), benzodiazepines and related drugs (N05BA, N05CD, N05CF), and attention-deficit/hyperactivity disorder medications (N06BA); use of antidiabetic drugs other than GLP-1 agonists (A10 excluding A10BJ); temporal order of GLP-1 medication; and time since cohort entry. aHR indicates adjusted hazard ratio.
Figure 2. Risk of Hospitalization Due to Somatic Reasons and Suicide Attempt The use of individual glucagon-like peptide-1 receptor (GLP-1) agonists was compared with nonuse of GLP-1 agonists. Groupwise and use of specific alcohol use disorder (AUD) medications were compared with nonuse of AUD medications. Both of these models (A and B) were adjusted for time-varying use of psychotropic medications (antipsychotics, N05A; antidepressants, N06A; mood stabilizers, including carbamazepine, N03AF01; valproic acid, N03AG01; lamotrigine, N03AX09; and lithium, N05AN01), benzodiazepines and related drugs (N05BA, N05CD, N05CF), and attention-deficit/hyperactivity disorder medications (N06BA); use of antidiabetic drugs other than GLP-1 agonists (A10 excluding A10BJ); temporal order of GLP-1 medication; and time since cohort entry. aHR indicates adjusted hazard ratio.CC BY · PubMed Central

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Metadata

Authors
Lähteenvuo, M., Tiihonen, J., Solismaa, A., Tanskanen, A., Mittendorfer-Rutz, E., & Taipale, H.
Affiliations
  • University of Eastern Finland (FI)
  • Tampere University (FI)
  • Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Corresponding author
Lähteenvuo, Markku
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2025-01-01
Volume
82
Issue
1
Pages
94
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2024.3599
PMC
PMC11561716
OpenAlex
W4404319582
Cited by
134
References
13
Citations by year
2026: 68 · 2025: 66
FWCI
40.89
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Psychiatry (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • Tampere University Institutional Repository (Tampere University) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
alcoholism, semaglutide, liraglutide, GLP-1 receptor agonists, drug repurposing, alcohol-related hospitalizations, suicide attempts, alcohol consumption reduction, type 2 diabetes, obesity, Sweden
MeSH terms
Liraglutide, Semaglutide, Adolescent, Adult, Alcoholism, Glucagon-Like Peptides, Female, Hospitalization, Humans, Hypoglycemic Agents, Male, Middle Aged, Sweden, Cohort Studies, Young Adult

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