Frequently Asked Questions

This case series found that semaglutide prescribed for weight loss was associated with marked reductions in Alcohol Use Disorders Identification Test (AUDIT) scores in all 6 patients who screened positive for hazardous drinking or alcohol use disorder at baseline. The mean AUDIT score fell from 14.0 ± 3.9 at intake to 4.5 ± 2.0 at follow-up, with a mean decrease of 9.5 ± 2.7 points (paired t5 = 8.50, P < .001). At follow-up, all 6 patients had AUDIT scores in the low-risk drinking range.

Every patient in the series had a lower AUDIT score after starting semaglutide. The individual decreases were 8 points, 14 points, 10 points, 7 points, 11 points, and 7 points, with follow-up intervals ranging from 1 month to 9 months.

No. The authors specifically noted that AUDIT score reductions were seen even in patients with minimal weight loss. For example, one patient lost only 1% of total body weight over 1 month but had a 7-point AUDIT reduction, which the article described as a 77% decrease.

The study was a retrospective chart review conducted in an interdisciplinary obesity medicine and bariatric surgery clinic. Investigators reviewed 79 new patients seen from March 2022 to October 2022 and identified those who had a positive baseline AUDIT screen, defined as a score of 8 or higher, and were later prescribed semaglutide for weight loss; 6 patients met those criteria and were included in the case series.

The series included 6 adult patients from an obesity medicine and bariatric surgery clinic who had positive AUDIT screens before starting semaglutide for weight loss. Patients were predominantly female (83.3%), had a mean age of 43.5 ± 12.3 years, and had baseline AUDIT scores ranging from 9 to 20. Their clinical histories included conditions such as binge eating disorder, bipolar I disorder, depression, attention-deficit/hyperactivity disorder, hypertension, hypercholesterolemia, prediabetes, and prior bariatric surgery.

Improvement was observed across the semaglutide doses used in this series. Three patients received 0.5 mg weekly, 2 received 0.25 mg weekly, and 1 received 1 mg weekly.

Yes. One patient was also prescribed topiramate 100 mg for weight loss, and the authors noted that topiramate is sometimes used off-label for alcohol use disorder. That patient had the largest absolute AUDIT reduction, from 20 to 6, so the article states that this response could reflect semaglutide, topiramate, or a combined effect of both drugs.

No patient in this case series reported side effects from GLP-1 receptor agonist therapy. The authors also stated that, to their knowledge, there are no alcohol use disorder-specific risks or contraindications that would prevent patients with alcohol use disorder from receiving GLP-1 receptor agonists, although they added that semaglutide likely would not be appropriate for patients with a BMI near or below 18.5 kg/m2 because of its weight-loss effects.

No. The authors described the findings as promising but stated that randomized, placebo-controlled clinical trials are still needed to establish the efficacy and safety of semaglutide for treating alcohol use disorder. They specifically concluded that, until those data are available, evidence-based practice requires clinicians to direct patients toward psychological and pharmacologic interventions for alcohol use disorder that have already been validated.

The main limitations are that this was a small retrospective case series with only 6 patients, no control group, and possible confounding factors. The authors noted possible self-selection bias, the possibility that completing the AUDIT questionnaire itself may have changed drinking behavior, variable follow-up intervals, only 2 measured time points, and the inability to determine from these data whether the reduction in AUDIT scores persists long term.