We could soon add smoking, alcohol consumption, cannabis use disorder and even compulsive shopping to the list of conditions that possibly the best known molecule on the planet for some time, semaglutide (marketed under the names of Ozempic, Wegovy or Rybelsus) is able to process.
First developed for the treatment of type 2 diabetes, glucagon-like peptide-1 (GLP-1) receptor agonists (such as exenatide, liraglutide, dulaglutide and semaglutide) have seen their popularity exploded when it was found that they could promote weight loss in certain patients, in particular by increasing the feeling of satiety.
The scientific community is now detecting what are known in the field as “signals” that promise to combat smoking and cannabis use disorder, reduce alcohol consumption, and even help control compulsive shopping.
“The effects of GLP-1 appear to extend not only to food satiety, but also to drug craving and various other behavioral disorders (e.g., compulsive buying), involving the perceived pleasure of drug consumption. substances,” we can read in a study published this summer by the journal Brain Sciences.
These different behaviors have in common that they activate the brain’s reward mechanisms ― that sweet euphoria caused by the first cigarette in the morning or the purchase of a new television ― and it is these mechanisms that semaglutide and the others molecules of the same kind might be able to influence.
The scientific evidence remains very thin for the moment, said Dr.r Didier Jutras-Aswad, a psychiatrist from the addiction psychiatry department of the CHUM, but there are still reasons to be “optimistic”.
“I usually preach caution, because there are many supposedly “miraculous” discoveries which, ultimately, have done nothing for the population,” he recalled. I think that [le sémaglutide] can be a source of hope, and at the same time I think that we have a lot to do before confirming that it can really have the virtues that we attribute to it. »
Reduction in consumption
The first signals appeared when patients who had been prescribed semaglutide to improve their metabolic profile subsequently reported a reduction in their alcohol and tobacco consumption.
Studies then revealed that, “in animal models, this molecule does indeed seem to have a positive impact on markers of substance consumption,” said Dr.r Jutras-Aswad.
“And now, when we look retrospectively,” he added, “we notice that people treated with this molecule and who were already consuming a substance tend to reduce or consume the substance less. »
A small randomized clinical study, carried out in the United States with only around fifty patients, found that semaglutide could reduce excessive alcohol consumption. “It’s far from being a robust enough study, but it’s a signal,” he said.
Other studies go further back and indicate that treated people will then be less likely to develop problematic alcohol consumption, indicated the Dr Jutras-Aswad.
The molecule could in theory be used in the treatment of other addictions, but we must remain “extremely cautious”, he said.
“We have other molecules like that, which have similar mechanisms or which have a bit of this effect, and which have proven useful for certain dependencies, but not for others,” recalled Dr.r Jutras-Aswad.
“Even when there are biological mechanisms that are involved in a disease, sometimes even when we correct these mechanisms, that does not always mean that it is sufficient to really have a positive impact. »
We already have effective treatments to help patients who want to reduce their alcohol or tobacco consumption, he added. These treatments are not perfect, they do not meet everyone’s needs, but “we want people first and foremost to use treatments that are recognized as effective before taking treatments for which this demonstration has not been demonstrated.” not been done.”
There is indeed a risk, since semaglutide and its cousins are available on the market, that people manage to obtain it for self-treatment, warned the Dr Jutras-Aswad.
“We have plenty of history of that,” he recalled. People self-treat for conditions, the treatment in question will not be helpful, and obviously this is without taking into account the side effects which can be harmful. »