Ozempic and GLP-1s to Treat Alcohol Abuse
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What is the main topic discussed in this episode?
The missing link between scientific journals and relationship counseling. The Last Show with David Cooper. Ozempic, it's the hottest thing right now touted for weight loss.
What is the potential of Ozempic in treating alcohol use disorder?
But what if there's another revolution in the drug's path, using it to turn down alcohol cravings? The results on that use are good. I am here with someone who's done research in this area. He's a physician and scientist at the National Institutes of Health. His name is Dr. Lorenzo Leggio. Lorenzo, welcome to the program. Thank you, David. Thanks for having me. Before we get to how many people are actually using Ozempic for alcohol use disorders, how effective is it based on the research?
Is it a good tool to treat alcohol addiction? Well, that's a great question, David. So we don't know yet. We are working on that. We have actually quite robust research. Very promising, growing literature in animal models, mouse and rat models that they drink excessively, that show that when we give GLP-1 drugs, such as the semaglutide, which is commercially known as Ozempic, Wegovy, Rebalsius, etc., these animals will drink less alcohol. We also know from human research, in particular looking at the big data through electronic medical records, that the people who are on these medications, they tend to drink less alcohol compared to people who are not on these medications. Now, these studies are not what we call randomized controlled trials, which sounds like a bunch of boozy words, but it's actually the gold standard how we develop new medications in medicine.
And so we do have at least one already published randomized controlled trial that shows that compared to placebo, semaglutide GLP-1 works better. But we need more of these randomized controlled trials to make a final decision. a claim that, in fact, that's the case.
Now, I'm not a doctor, in case you're wondering, so correct me if I'm wrong, but my understanding is once a drug hits the market and it's proven safe for the general public, doctors can use it in a process called off-label prescription for things that they think it could help for. Because Ozempic is known to be safe, and I'm sure there are people who have alcohol use disorder who talk to their doctor, when they do get prescribed it off-label, what are they saying?
Right, that's a great question. So a couple of things. There are people who anecdotally report that they receive a prescription of a GLP-1 medication, either off-label for alcohol craving, alcohol addiction, or they get the prescription for diabetes, obesity, which is not off-label, but they also report these reductions in alcohol drinking. So that's, in fact, something that has been reported over and over, although anecdotally. And I keep on emphasizing anecdotally because, of course, people who may not hear these facts may not report, may not say, hey, I'm drinking less if they don't. So the data may be a little skewed in a way, and this is exactly why we need controlled trials.
Clinical trials, yeah.
In terms of label, David, I will clarify. So in order for a physician to prescribe a patient to consent and agree to use a medication of label, there must be evidence not only of safety, which is a must, but also of efficacy, even if the drug is not approved in the market. Got it. We have examples. For example, we have actually three medications approved by the FDA for people with alcohol use disorder.
How effective is Ozempic based on existing research?
Natrexone, Acamproset, Desofram. We have two more medications that are called Pyramid and Gabapentin. Sometimes the people, clinicians use off-label with the consent of the patient. These medications are endorsed by the American Psychiatric Association as a second-line treatment. And that's an example of off-label use.
I'm actually prescribed gabapentin off-label for some mental health stuff, even though it's used. Anyway, okay. I want to talk about alcohol abuse and people who have it. If I had some other illness, mental health problem, and I went to talk to a doctor, it would be likely or possible that I would get prescribed medication.
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