GLP-1 analogues, the next treatment for addictions?

GLP1 analogues are indicated for the treatment of type 2 diabetes and obesity. However, they could also have a benefit in the treatment of addictions, particularly in alcohol and smoking cessation.

Exenatide (Byetta), dulaglutide (Trulicity)… GLP-1 analogues, currently indicated in the treatment of type 2 diabetes and obesity, do not only have these strings to their bow. Cardioprotective, neuroprotective and nephroprotective effects have already been demonstrated, and they could also have a future in the treatment of addictions, as suggested by a review of the literature published in “Drug and alcohol dependence” on November 1. In this work, the researchers collected all the studies on the subject. Finally, they only retained five randomized trials versus placebo, which analyzed the effects of exenatide and dulaglutide on the consumption of alcohol, nicotine and cocaine. 630 participants were included, over periods varying from 6 to 26 weeks.

The results, however, are uneven. Indeed, of the 5 studies, only two detected a significant reduction in substance use disorder in the treated group compared to the placebo group: one concerning alcohol consumption and the other concerning tobacco consumption. . The third study did not detect a significant effect of GLP-1 analogues on alcohol consumption, but observed an effect in a subgroup of obese participants. The fourth study found no significant effect of GLP-1 analogue administration on the subjective effects of cocaine. Same for the 5^e study which studied dulaglutide, and which found no effect on cocaine consumption, nor on the rate of smoking abstinence.

“Even if the number of relevant studies published is still small, the results are not completely concordant and they only concern alcohol and tobacco, these results suggest a potential role of GLP-1 analogues in the treatment of addictions »conclude the authors, who assume an action of GLP-1 analogues on receptors which are expressed in regions of the brain considered to be involved in reward and addiction.