An Update on GLP-1 Receptor Agonists as Pharmacotherapies for AUD

In this Mental Health Minute, Mehdi Farokhnia, MD, MPH, of theNational Institutes of Health (NIH) Intramural Research Program, the National Institute on Drug Abuse (NIDA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) shares highlights from “Glucagon-like peptide-1 (GLP-1) receptor agonism as a potential pharmacotherapy for alcohol use disorder: converging evidence from rodent and early human studies,” a presentation he delivered as part of the Pharmaceutical Pipeline Update at the 2024 American Society of Clinical Psychopharmacology (ASCP) Annual Meeting. The full transcript is below.

My name is Mehdi Farokhnia. I am a physician-scientist at the NIH Intramural Research Program and am affiliated with NIDA and NIAAA. What I presented on was some preclinical and pharmacopeia studies with GLP-1 receptor agonist and [dipeptidyl peptidase-4] (DPP-4) inhibitors on alcohol intake.

GLP-1 receptor agonists are becoming more and more popular. There are some anecdotal reports showing that they reduce alcohol intake. So, first we tested in animal models of alcohol, binge drinking, and dependence-induced alcohol intake. We saw that GLP-1 receptor agonists reduce alcohol intake, but DPP-4 inhibitors that are also approved for diabetes did not—there was no effect seen with those.

Then we looked at electronic health records data—a large data set with the [United States Department of Veterans Affairs]—and we saw that, compared to people who did not get any of these drugs, GLP-1 receptor agonists, had reduced alcohol intake—and consistent with our preclinical data, we also saw that DPP-4 inhibitors did not. So…it seems that GLP-1 receptor agonists are promising medications for addiction and alcohol use disorder. Obviously, clinical trials testing GLP-1 receptor agonists need to be done; these are ongoing in our program and at other universities.

There has been a lot of attention in the media about GLP-1 receptor agonists. They have been very promising medications for weight loss and diabetes. Again, like the anecdotal reports, they seem to be very promising, and the data that we showed are also very promising. But what we want everyone to know is that we already have [US Food and Drug Administration]-approved medications for alcohol use disorder, and we do not really know unless we have data from clinical trials whether these medications are going to be effective or not.

Until we have data from clinical trials, we should rely on already approved medications to treat people with alcohol use disorder. But it seems very, very exciting to be adding another tool to the toolbox for physicians to treat alcohol use disorder.

Dr Farokhnia is a physician-scientist at the NIH Intramural Research Program who is affiliated with the NIDA and the NIAAA.