Dr. Ahmed
Did you know that certain medications like Mounjaro, Wegovy, Ozempic, Rybelsus, Trulicity, Victoza, and Saxenda could potentially help with alcohol use disorder?
These medications fall under a group called GLP-1 analogs (Mounjaro is a dual GLP-1 and GIP analog). These medicines are primarily used to treat diabetes and obesity, their use as a treatment for alcohol use disorder is an exciting and emerging area to explore.
Just like reducing food cravings, these drugs, especially the latest GLP-1 analogs Ozempic and Rybelsus also reduce cravings for alcohol, coffee, and other beverages and drinks.
The mechanisms by which Ozempic and Rybelsus reduce alcohol cravings are diverse but an important one is that it affects the “reward system” in the brain which may help individuals overcome alcohol addiction.
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Do Studies Support Using Mounjaro, Ozempic, and Rybelsus for Alcohol Addiction?
There are a few animal studies to support the use of GLP-1 analogs for treating alcohol addiction.
In one study conducted on rodents, it was found that Semaglutide and Liraglutide use resulted in a voluntary reduction in alcohol intake.
The author suggested that among all the drugs tested, GLP-1 analogs were found to be most potent in reducing voluntary alcohol intake [Ref].
The author also suggested that Semaglutide is a better option compared to Liraglutide in treating alcohol use disorder.
In another study, the authors concluded that Exenatide (Byetta, Bydureon) diminished the reward signals in the brain which are stimulated by alcohol [Ref].
In another publication, the authors suggested that GLP-1 antagonists increase alcohol intake while GLP-1 analogs prevent the activation of dopamine in the reward center of the brain, the mesolimbic system which is stimulated by addictive drugs including cocaine and alcohol [Ref].
Another nationwide cohort of patients who were using either DPP-IV inhibitors or GLP-1 analogs were evaluated for the effects of these drugs on alcohol intake. GLP-1 analogs were associated with a lower incidence of alcohol-related events compared to DPP-IV inhibitors (Hazard Ratio of 0.46) [Ref]
In another randomized controlled trial, Exenatide (Byetta) did not result in reducing the number of alcohol-free days, although it did attenuate the reward system of the brain [Ref]
Alcohol is available and used commonly worldwide. Alcohol use disorder has many adverse health implications and treatment options are limited with modest efficacies.
Currently, all eyes are on the novel GLP-1 analogs, Semaglutide in particular, as a novel treatment modality for alcohol dependence.
To study the effect of the various GLP-1 analogs in individuals who were alcohol-dependent, we collected data from various social platforms to study the effect of GLP-1 analogs on alcohol intake, hangover, and gastrointestinal side effects.
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Mounjaro, Wegovy, Ozempic, Rybelsus, and Alcohol Use:
We collected data from social media platforms, primarily Reddit, to evaluate the real-life patients’ experiences using GLP-1 analogs and their impact on alcohol use, dependence, and side effects.
A total of 213 pre-defined questionnaires were filled. Most patients were using Semaglutide, some were on Mounjaro, and others were using Liraglutide or those who switched from Semaglutide to Mounjaro or vice-versa.
The pie chart below demonstrates the percentage of patients in each group:
The table below summarizes the number of patients in each group:
Medication | Number | Percentage |
| Semaglutide | 83 | 39% |
| Ozempic | 74 | 34.70% |
| Rybelsus | 26 | 12.20% |
| Mounjaro | 17 | 8% |
| Wegovy | 9 | 4.20% |
| Others | 4 | 1.90% |
Although Ozempic, Wegovy, and Rybelsus are formulations of Semaglutide, we separately mentioned Semaglutide because it was not mentioned by the patients as to which formulations they were using.
Alcohol Intake was reduced in a significant number of patients compared to those who noticed no change and those who noticed that their intake increased with GLP-1 use.
The chart below summarizes the percentage and number of patients who noticed a change in their alcohol intake:
The table below summarizes the same data:
Alcohol Intake | Number | Percentage |
| Alcohol Intake Reduced ⇓ | 171 | 80.3% |
| No Change ⇔ | 39 | 18.3% |
| Alcohol Intake Increased ⇑ | 3 | 1.4% |
Weight loss correlated with reduced alcohol intake and was reported by 80% of the patients.
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Why do patients reduce their Alcohol intake while on Semaglutide and Tirzepatide (Mounjaro)?
Among the 171 participants who reported reduced alcohol intake, we found that most patients simply did not have the urge to drink alcohol.
The table below summarizes the results:
Why Alcohol Intake Reduced | No. | % |
| Side effects (Gastric issues) | 34 | 19.9 |
| Both No Desire plus Side effects | 27 | 15.8 |
| No Desire to Drink Alcohol | 101 | 59.1 |
| Not drinking so as to lose more weight | 4 | 2.3 |
| Other side effects such as a hangover the next day | 8 | 4.7 |
More than half of the participants had no desire to drink alcohol. Their cravings were suppressed with the use of Semaglutide (Ozempic and Rybelsus) and other GLP-1 analogs as well as Mounjaro (Tirzepatide).
In addition, a significant number of the participants did not want to drink alcohol because of the side effects. Most stomach-related side effects that were reported were:
- Nausea
- Vomiting
- Abdominal fullness
- Bloating
- Gases, and
- Stomach pain.
The picture below summarizes the results of the 171 participants who noted a reduction in their alcohol intake:
Comments of people who were not been able to drink or those who did not have the desire to drink more:
I’ve been fine drinking on it, but I just can’t drink as much! which is a blessing to me because I was a really bad binge drinker before this. just another reason I love this medicine. |
The only side effect I’ve had concerning Rybelsus and alcohol is that I just don’t crave it as much. I know that makes me sound like a raging alcoholic, but before Rybelsus I had a glass every night; now I might drink some during the weekend…maybe. |
| My alcohol cravings really reduced! |
| My interest in alcohol is GREATLY reduced. It just seems way less appealing so I haven’t had much to drink since starting Ozempic. I went to one party where I overindulged a bit and felt pretty hung over — I probably drank less there than I would have to have had to get a similar hangover off the medication. However, I’ve had the occasional glass of wine or beer with no issue other than what others have mentioned about it increasing the feeling of fullness and making it hard to eat, esp with beer. |
| I have that experience as well. I normally look forward to a couple of drinks every evening. Now, on semaglutide, I have no desire to drink at all. I kinda miss it |
I’ve been on Rybelsus for 15 months. Still very little desire for alcohol. As a previous poster mentioned, there seems to be data suggesting there’s a link. I think it has to do with the reward center in the brain. |
It works well for anything that may have an addictive potential. Food at its core is a drug, and Semaglutide helps you feel full but also decreases all cravings. |
| I, too, was a heavy drinker. Now, I’ll have one drink or two, even on a guys night out, and usually no more than one. Every heavy drinker I know who has taken Semaglutide has essentially reverted to light, social drinking. Though admittedly, this is anecdotal, from what I’ve seen, Semaglutide seems to work better at reducing drinking than even the best anti-drinking medication available. Side |
I started semaglutide about 6 months ago and have found that I have ZERO desire for alcohol. I was never a heavy or frequent drinker. I’ve noticed that even socially drinking really doesn’t sound great. |
How do GLP-1 analogs help alcohol addiction?
The exact mechanism is yet to be identified. However, the following mechanisms may all play a role:
GLP-1 analogs alter the reward system of your brain:
Normally, when people drink alcohol or take a drug that has the potential for addiction, this is because the brain’s reward system is activated. Certain neurotransmitters are released, creating euphoria and a special sense of being happy.
These neurotransmitters, dopamine being the primary one, reinforce the urge for more alcohol. This addiction potential of alcohol is also enhanced by the fact that people develop tolerance to it.
Tolerance is a term when people need more and more alcohol to get the same effects as they had in the start. At this time the person becomes an alcoholic and develops organ dysfunction such as liver cirrhosis.
GLP-1 analogs make a person feel full:
GLP-1 analogs such as Ozempic and Rybelsus make a person feel full all the time. With Ozempic or Rybelsus, you simply don’t have the desire to take more because your stomach is full and you are scared that you might throw out if you take more.
In addition, the booze effect of alcohol is blunted or delayed. People do not get the amount of satisfaction they used to get before GLP-1 analogs.
Stomach side effects:
The most common side effects of Semaglutide (Ozempic, Rybelsus, and Wegovy), Liraglutide, and Mounjaro are related to the stomach.
People may develop severe nausea, vomiting, heartburn, sulfur burps, and abdominal pain if they drink too much alcohol while simultaneously using a GLP-1 analog.
In fact, most participants who were scared of these side effects experienced severe vomiting episodes and abdominal pain for which some had to visit the hospital.
Another important side effect of both incretin mimetic drugs (GLP-1 analogs and Mounjaro) and alcohol is pancreatitis. People are more likely to develop pancreatitis compared to those who do not take alcohol.
Alcohol may impair your weight loss goals:
Alcohol use makes you more hungry and increases your cravings for food with a high glycemic index. This is opposite to what Semaglutide and Mounjaro do.
Moreover, it’s important to note that alcoholic beverages contain calories. When consumed in excess, alcohol can contribute to exceeding your daily calorie intake, which can hinder your weight loss progress.
It’s crucial to be mindful of the caloric content of alcohol and consider its impact on your overall calorie consumption if you’re aiming to achieve weight loss goals.
Here is a table demonstrating the amount of calories in an alcoholic drink:
Alcoholic Drink | Serving Size | Approximate Calories |
| Beer | 12 fl oz | 100-200 |
| Wine | 5 fl oz | 120-150 |
| Spirits | 1.5 fl oz | 90-110 |
| Vodka | 1.5 fl oz | 97 |
| Whiskey | 1.5 fl oz | 105 |
| Rum | 1.5 fl oz | 97 |
| Tequila | 1.5 fl oz | 97 |
| Gin | 1.5 fl oz | 97 |
| Brandy | 1.5 fl oz | 110-130 |
| Liqueurs | 1.5 fl oz | Varies |
| Cider | 12 fl oz | 150-200 |
| Mead | 5 fl oz | 150-200 |
| Sake | 5 fl oz | 120-150 |
The risk of hypoglycemia:
Since most people on GLP-1 analogs use them for diabetes control, alcohol intake may increase the risk of hypoglycemia.
Alcohol is readily metabolized. It causes a sudden spike in your blood glucose followed by hypoglycemia. This effect is especially enhanced when the person is on insulin or other diabetes medications.
Hangover:
Combining a GLP-1 analog with alcohol can result in some participants experiencing a “hangover” as a side effect.
This occurs due to the GLP-1 analog’s effect on slowing down gastric emptying, which delays the absorption and effects of alcohol.
As a result, the impact of alcohol can be prolonged and sustained, leading to a lingering hangover sensation.
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In Conclusion:
Semaglutide, Ozempic, and Rybeslus in particular, and Tirzepatide are diabetes medications but have the potential to become a cure for alcohol addiction.
In our study, we found that GLP-1 analogs can have various effects. The most important one is that people lose the desire to drink alcohol.
Some participants developed severe GI upset and had to reduce their alcohol intake. Scientists and researchers need to actively study novel diabetes medications for treating alcohol-use disorders.
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