Oral semaglutide didn’t differ from placebo in reducing laboratory-assessed alcohol craving in adults with alcohol use disorder (AUD) but it did reduce heavy drinking days and drinks per day, according to a study issued today by AJP.Why It’s Relevant
There is mounting evidence that glucagon-like peptide-1 receptor agonists such as semaglutide help people with AUD reduce their drinking, particularly individuals who are overweight or obese. However, most studies have involved subcutaneous GLP-1RAs; more research is needed with newer oral formulations that hold the promise of broadening access to this class of medications.
By the Numbers
- Fifty treatment-seeking adults (94% White) with moderate-to-severe AUD who were also overweight or obese were randomized to receive oral semaglutide (titrated from 3mg/day to 7mg/day) or placebo for eight weeks.
- After six weeks, participants given oral semaglutide didn’t differ significantly from those given placebo in their self-reported craving for alcohol after holding and smelling their preferred alcoholic beverage for three minutes.
- However, those taking semaglutide significantly reduced their average drinks per drinking day compared with those on placebo over the last four weeks, and also reported fewer alcohol cravings and fewer negative alcohol consequences outside the laboratory setting .
- Semaglutide was well-tolerated, had few adverse-event-related dropouts, and had rates of gastrointestinal and other adverse events similar to other populations.
What’s More
The disparate findings related to alcohol craving raise the question of whether a single item is optimal for assessing craving in AUD medication trials, the researchers noted.
The Other Side
The findings may not generalize to non-White, Hispanic, lower-weight, and/or less cue-reactive individuals, such as those who drink for “relief” rather than “reward,” the researchers wrote. It is also unclear if semaglutide would remain effective in the long term.
Takeaway Message
“[T]hese data hint that semaglutide’s effects on heavy drinking may be greater than other FDA-approved AUD medications’ small to medium effects,” the authors wrote. “Semaglutide should be tested head-to-head against these medications.”
Related Information
Source
Joseph P. Schacht, et al. Oral semaglutide for alcohol use disorder: a randomized clinical trial. The American Journal of Psychiatry. Published July 29, 2026. doi:10.1176/appi.ajp.20260003
(Image: Getty Images/iStock/Ranimiro Lotufo Neto)
