All six patients prescribed semaglutide for weight loss who also had alcohol use disorder showed significant improvement in AUD symptoms, with an average AUDIT score decrease of 9.5 points.
9.5-point AUDIT score decreaseThe mean improvement in alcohol use disorder symptom scores across all 6 patients treated with semaglutide for weight loss
What the researchers found
All 6 patients (100%) with positive Alcohol Use Disorder Identification Test (AUDIT) screenings showed significant reduction in AUD symptoms after starting semaglutide therapy for weight loss. The mean AUDIT score decreased by 9.5 points, a statistically significant improvement (P value reported as significant via paired t-test).
This clinical observation is consistent with preclinical animal data showing that GLP-1 receptor agonists can reduce alcohol consumption. Currently, only 3 FDA-approved medications exist for AUD treatment, making the potential of semaglutide as an additional option clinically meaningful.
Why it matters
Alcohol use disorder is a leading cause of preventable death worldwide, yet only three FDA-approved drugs exist to treat it. If semaglutide and other GLP-1 receptor agonists can genuinely reduce alcohol cravings and consumption — as both animal studies and now this human case series suggest — it could open an entirely new treatment avenue for a condition that remains stubbornly difficult to manage.
How the study worked
The researchers conducted a retrospective chart review to identify patients prescribed semaglutide for weight loss who also had positive AUD screenings (AUDIT score > 8) before starting semaglutide. Six patients meeting these criteria were identified. Their AUDIT scores before and after semaglutide therapy were compared using a paired t-test.
What this study cannot tell us
This is a case series of only 6 patients with no control group, no randomization, and no blinding. The retrospective design means the findings could be influenced by confounding factors — for example, patients may have changed drinking behavior due to nausea from semaglutide, weight loss motivation, or other lifestyle changes. The AUDIT score improvement could partially reflect reduced caloric intake from alcohol rather than reduced craving specifically. Much larger randomized controlled trials are needed.
How to read the evidence
This is a retrospective case series of 6 patients with no control group. While the 100% response rate is notable and the statistical test showed significance, the very small sample size, lack of randomization, and retrospective design place this at a low evidence level. It serves primarily as hypothesis-generating for future controlled trials.
When this study was published
Published in 2023, this case series emerged during the height of interest in GLP-1 drugs' unexpected effects beyond weight loss and diabetes. Several larger studies examining semaglutide and alcohol use are now underway.
The bigger picture
This case series is part of a growing wave of clinical observations suggesting GLP-1 receptor agonists like semaglutide may have effects well beyond glucose control and weight loss. Reports of reduced cravings for alcohol, nicotine, and other substances have emerged alongside the massive adoption of these drugs. Understanding whether GLP-1 signaling directly modulates reward pathways could reshape addiction treatment — but rigorous randomized controlled trials are needed to move beyond anecdote.
Questions still open
- Does semaglutide reduce alcohol consumption through direct effects on brain reward pathways, or indirectly through appetite suppression and nausea?
- Would the AUD symptom improvement persist if semaglutide were discontinued?
- How do the effects of semaglutide on AUD compare to existing FDA-approved treatments like naltrexone?
Common questions
What is the AUDIT score and what does a 9.5-point decrease mean?
Should people take semaglutide to treat alcohol problems?
Read the original research
Significant Decrease in Alcohol Use Disorder Symptoms Secondary to Semaglutide Therapy for Weight Loss: A Case Series.
The Journal of clinical psychiatry, 85(1)
Citation
Richards, Jesse R; Dorand, Madisen Fae; Royal, Kyleigh; Mnajjed, Lana; Paszkowiak, Maria; Simmons, W Kyle. (2023). Significant Decrease in Alcohol Use Disorder Symptoms Secondary to Semaglutide Therapy for Weight Loss: A Case Series.. The Journal of clinical psychiatry, 85(1). https://doi.org/10.4088/JCP.23m15068