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THE diabetes medicine Ozempic has been hailed as a miracle drug that can lead to rapid and dramatic weight loss.
That alone caused a stir on social media, but on top of that, people using this injectable drug (also prescribed as Wegovy to treat overweight and obesity) report a surprising side effect: disinterest in a variety negative behaviors ranging from smoking and nail biting to impulse buying and binge eating.
The impact of these drugs on the urge to drink alcohol is currently receiving the most attention. “You don’t feel like it, you don’t even think about it,” says Jeff Kob, a 69-year-old securities attorney based in Coronado, Calif.
For the past four years, Kob has struggled with orthopedic issues. He had a hip replacement and spine surgery, and is weeks away from knee surgery. No longer able to indulge in passions such as running, skiing and road biking, he found himself “relatively immobilized”, which made him fat. Bored and frustrated, he found himself drinking more than before, which led to even greater weight gain.
Then his doctor prescribed Ozempic to help him lose weight before the next knee operation.
“If I was sitting at home bored, maybe I’d go for a drink. Now I don’t even want to do that. I noticed I didn’t feel like drinking anymore and I quit hard liquor,” Kob says, noting that he lost 15 pounds.
His experience adds to a growing library of anecdotal stories of patients taking semaglutide, the active ingredient in Ozempic and Wegovy. Today, the medical community wonders: can this class of drugs really treat addiction?
How do drugs like Ozempic work?
Semaglutide, originally developed for diabetes, belongs to the family of drugs known as GLP-1 agonists. According Lorenzo Leggio, MD, Ph.D.senior researcher and physician-scientist at the National Institutes of Health, drugs like Ozempic mimic GLP-1, a hormone produced by the gut in response to food that instructs the pancreas to release insulin, thereby regulating blood sugar and reducing hunger.
“It suppresses your appetite and does so for a longer period of time [than the body is able to do on its own]says Dr. Leggio. Because semaglutide stays in the body longer than the hormone GLP-1, he explains, the result is a lasting feeling of fullness that stifles the desire to eat.
Scientists are just beginning to study the impact of semaglutide on other types of food cravings. Leggio published a study on May 16 in the journal JCI Overview showing that semaglutide reduces alcohol consumption in rodents. It suggests that the drug may alter GABA neurotransmitterswhich are implicated in the development and treatment of alcohol use disorders.
Semaglutide may affect ‘reward centers’ in the brain
Scott Kanoski, Ph.D., a neurobiologist at USC Dornsife in Los Angeles, says semaglutide can affect reward centers in the brain. In rodent research published in Molecular psychiatry in July 2019, he and his team discovered that this class of drugs could act on the hippocampus, one of the brain regions that controls certain aspects of eating behavior, including the impulse to keep eating “tasty” foods. The study notes, however, that further research is needed to unravel the underlying mechanisms.
“One way this could happen is by reducing the ability of reward signals to initiate the release of dopaminewhich is a biological currency for motivation and reward in the brain,” says Dr. Kanoski.
People who take drugs like Ozempic and Mounjaro (tirzepatide, another GLP-1 agonist) may not feel this “high” well-being following experiences that would normally lead to a dopamine gain – including activities like nail biting and compulsive shopping .
While most research on semaglutide so far has focused on food intake, Kanoski says the latest animal studies have revealed that this class of drugs may also act in the brain’s reward circuitry to reduce cravings for other substances such as alcohol and cocaine.
Clinical trials are investigating the long-term impacts of Ozempic
Through new clinical trials, researchers will learn whether what they’ve found in rodent studies also applies to humans, perhaps confirming what patients on semaglutide feel about their lack of desire for sex. ‘alcohol.
“I’ve had a number of patients in the clinical trials we run with questions like, ‘Hey, I noticed I don’t find alcohol appealing’ or ‘I was out and didn’t feel just don’t like drinking,’ and if it could be drug-related,” says Jena Shaw Tronieri, PhDassistant professor of psychiatry and clinical services at the Center for Weight and Eating disorders at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.
It is enrolling 120 obese patients taking semaglutide for a 72-week clinical trial to study the drug’s long-term effects on appetite.
Meanwhile, Leggio is planning a double-blind, placebo-controlled clinical trial focused on how semaglutide affects patients with alcohol addiction.
They hope their research will help find answers to key questions, such as decreasing the desire to drink or overeat, who is best for this drug, and what the optimal dosage may be.
“To answer all three questions, it’s important that we make what we call the ‘gold standard’ in clinical drug development,” says Leggio. “This gives us hope that semaglutide brings about changes in the brain that we can translate to help people with addictions.”
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