7 ms·

Semaglutide treatment associated with high reduction in Alcohol Use Disorder

51 points by belltaco 3y ago

petesergeant 3y ago
Doesn't surprise me that much. I'm on tirzepatide, and I still enjoy the occasional drink, but it hits harder, the hangovers are worse, and I no longer get the sugar rush I used to. Same as candy, in a way -- I still like to have an occasional frozen yogurt, but I no longer crave a second one immediately after I finish the first, and it doesn't sit that well, so it's become a sometimes treat rather than something I have to make a real effort to stop myself ordering at the end of the day. I have a friend who works on reservations in Canada, who says they hand it out like candy there -- the health outcomes for people who are obese are like magic, and I have to imagine a reduction in AUD is a massive side-benefit for a population notably at risk. Lost ~20lbs in 10 weeks.
- coffeebeqn 3y ago
  Are these a magic pill or are there bad side effects?
  - petesergeant 3y ago
    Basically a magic pill (well, injection). Some mild nausea and indigestion at first, but nothing ginger tea and some over-the-counter antacids couldn't handle. Some people get severe nausea, and have to stop taking them. Only real issue at the moment is the high cost: $1k/month in the US, $500 rest-of-the-world, or cheaper in countries that subsidise them.
    - Scoundreller 3y ago
      > well, injection While I haven't any evidence about Tirzepatide in oral form, the results for semaglutide oral is pretty good. Haven't seen any oral vs injectable head-to-head studies of the same molecule though (funny how that is).
      - petesergeant 3y ago
        Sure, but it’s a PITA to take because absorption is bad. Take it on an empty stomach with exactly the right amount of liquid, and then nothing else in your stomach for 40m, and the gastrointestinal side effects are worse. I’m looking into using this for maintenance as I’ll be travelling a lot, but it’s much more of a hassle than the self-injecting needles
        Scoundreller 3y ago
        > Sure, but it’s a PITA to take because absorption is bad. That’s a dosing problem :) Unsure if the GI effects will actually worse. Depends if it’s a direct effect or not.
  - j4yav 3y ago
    I had to stop taking it because it increased my resting heart rate by about 25 bpm.
  - BryanLegend 3y ago
    They're modified hormones. Normal glutide made by the body has a 5 minute half life and makes you feel full. Semaglutide has a 1 week half life.
  - randcraw 3y ago
    5-10% of those taking GLP-1 agonists discontinue treatment citing nausea, diarrhea, indigestion, vomiting, and abdominal pain. Patients often must change not just how much they eat but what they eat, especially, reducing fat intake, eating smaller meals, and staying active right after eating. "What are the gastrointestinal adverse effects of the glucagon-like peptide 1 receptor agonists, and how should they be managed?" https://illinoisadvance.com/what-are-gastrointestinal-adverse-effects-glucagon-peptide-1-receptor-agonists-and-how-should-they-be-managed/ https://illinoisadvance.com/what-are-gastrointestinal-advers... "Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss" https://jamanetwork.com/journals/jama/fullarticle/2810542 https://jamanetwork.com/journals/jama/fullarticle/2810542
  - vl 3y ago
    The main bad side effect is that you need to be really conscious about food. It’s easy to eat not enough or not to eat at all. Then unavoidably you feel really weak and metabolism slows down. You need to be really conscious to eat enough healthy foods, especially if you want to exercise.
  - vrc 3y ago
    If you’ve ever had pancreatitis you can’t take this (me) because it increases overall risk of having an episode. If you’re unlucky like me and have a predisposition for pancreatitis or gallbladder issues, this can push you over the edge into the worst pain of your life and possible life threatening complications. But the percentage of folks at risk is relatively low so this is not a concern for most. Heavy alcohol consumption is a leading cause of pancreatitis so for folks with AUD and diabetes, if this cuts down both diabetes and the causal factor (drinking), maybe it’s a net positive if they’ve never had pancreatitis before. Unfortunately severe pancreatitis increases the risk of Type 2 and 3 diabetes and unfortunately this great treatment won’t be available.
isoprophlex 3y ago
> Recently, attention has turned to the possibility that semaglutide may have broader applications, including its potential impact on addictive behaviors such as reducing drug craving and alcohol consumption. Makes sense when your consider over-eating as addictive behavior. Considering there is a strong correlation between psychological trauma and addictive behavior as a coping mechanism, I wonder what happens to such people on Semaglutide. Will they find alternative coping mechanisms? Or does the physiological effect of of Semaglutide somehow soften the impact of the trauma underlying addictive behaviors? If these drugs cure trauma-derived addictive behaviors, that's just so extremely interesting, mechanistically. Really curious to know if this is true, and if we'll ever find out in which direction the causality goes.
- BryanLegend 3y ago
  They're modified hormones. Normal glutide made by the body has a 5 minute half life and makes you feel full. Semaglutide has a 1 week half life. It's amazing how much hormones control our minds.
  - Scoundreller 3y ago
    If we're measuring the duration of effect of hormones, shouldn't we measure the duration of whatever it signals/triggers the action of or release of, rather than the molecule/peptide itself? If whatever it signals has a shorter half-life, then yeah, the duration of effect is going to depend on the hormone's half life, but not if whatever it signals has a longer half-life of effect.
- amatic 3y ago
  > If these drugs cure trauma-derived addictive behaviors, that's just so extremely interesting, mechanistically. So much this. I think going off semaglutide makes the weight come back, so it would seem that semaglutide doesn't change the circuits of trauma and addiction permanently, but it does something to them. The theory that obesity is a result of food addiction is pretty revolutionary, and now having alcoholism confirmed to respond to the same drug really supports the theory. Additionaly, if both are caused by childhood or development traumas, that opens other treatment options, and maybe some forms of change in how we as a society look at addictions. But maybe I'm going too far.
steezeburger 3y ago
Just hit the mega baader-meinhof occurrence. I just learned about this peptide this morning. Clicked the link and it's a paper from my alma mater. Lead author and I share a first name. I'm 4 years sober. Fun coincidences!
deleted 3y ago
[deleted]
addisonj 3y ago
This is pretty interesting, but for anyone who is on semaglutide maybe not a huge surprise? At least in my experience with semaglutide, everything I consume I need less of and I feel way less desire for things. I am not a big sweet eater, but usually enjoy a decent sized chunk of dark chocolate about every other day. I still have roughly the same cadence of wanting a piece, but the difference now a single square is enough and I don't feel the need for more. It isn't like the desire for things like sugar, fat, etc is gone, it is more like I am just wayyy better at knowing how much of that I need. I have been on semaglutide for ~2 months and it has honestly been wonderful for me. I have described it as being the drug that helps my brain stop acting like we live in times of famine and has massively improved my relationship with food. It really is just a shame that it is so cost prohibitive as I genuinely think that it probably could do a ton to reduce healthcare and impact of food overproduction (I eat so much less meat and I have heard some from others), but I don't think that will happen unless insurance starts covering it
- jdmoreira 3y ago
  I've never tried it. Can I ask a follow up question? Do you feel less need of other "wants" as well? money, ambition, power, sex drive? Things in this vein. Sorry if I'm being awkward but I'm genuinely curious.
  - vl 3y ago
    No, it’s only food-related. Basically you feel hunger less. It’s easier to implement good diet. Obviously you need to eat healthy to get benefits from semiglutide.
    - seper8 3y ago
      Obviously you dont. Just the reduction of caloric intake and as a result, a reduction in body fat, is gonna lead to health benefits.
      - vl 3y ago
        I’m taking it, and it’s still trivial to overeat with calorie-dense food. It’s just easier to control impulse to do so.
dclowd9901 3y ago
> Semaglutide has made headlines recently as an FDA-approved drug for the treatment of diabetes under the name Ozempic, and weight loss under the name Wegovy. Given the only commonality between these two conditions, it almost seems like semaglutide is a synthetic version of the “you’ve had enough” protein.
- pjerem 3y ago
  I think we know that it’s exactly that. I have no source to cite but I’m pretty sure I read this somewhere.
  - krisoft 3y ago
    Absolutely. I recommend the references linked under “Mechanism of Action” of the wikipedia page: https://en.m.wikipedia.org/wiki/Semaglutide https://en.m.wikipedia.org/wiki/Semaglutide
- krisoft 3y ago
  Yes, that is exactly what it is. It is designed to mimick the action of the naturally occuring GLP-1 hormone. It is one part of the “you have just eaten” molecular signaling chain.
palemoonale 3y ago
[flagged]
- baq 3y ago
  Ozempic is a brand name for this. Some other names are Wegovy and Saxenda.
  - vl 3y ago
    Saxenda is liragludtide, which is similar, but different compound. Another brand name for semiglutide is Rybelsus - semiglutide in the tablet form to be taken daily.
  - palemoonale 3y ago
    I know! But people might be more interested / attentive when a brand is included compared to just $randommoleculecombotheyneverheardabout...
ehPReth 3y ago
man, I wish I could afford this. Insurance (in Canada) caps out at like $800/y for reimbursement and the cost is something like $1k/month :(
- vl 3y ago
  Looks like Rybelsus (semiglutide in pill form) is $300 in Canada.
  - ehPReth 3y ago
    oh interesting, thanks! I'll look into this
- ehPReth 3y ago
  sorry, can't edit this: but that's my (quite bad) insurance. not all insurance :)
FreeTrade 3y ago
I've long suspected that some excess alcohol consumption is a disguised form of overeating. It's socially acceptable for men to have a few beers in a way that it's not acceptable for them to have a few icecreams. I can well see semaglutide having a similar affect on that kind of use. But I wonder does it have the same effect on people drinking mainly to change their mental space.
aaron695 3y ago
[dead]

51 points by belltaco 3y ago

Doesn't surprise me that much. I'm on tirzepatide, and I still enjoy the occasional drink, but it hits harder, the hangovers are worse, and I no longer get the sugar rush I used to. Same as candy, in a way -- I still like to have an occasional frozen yogurt, but I no longer crave a second one immediately after I finish the first, and it doesn't sit that well, so it's become a sometimes treat rather than something I have to make a real effort to stop myself ordering at the end of the day. I have a friend who works on reservations in Canada, who says they hand it out like candy there -- the health outcomes for people who are obese are like magic, and I have to imagine a reduction in AUD is a massive side-benefit for a population notably at risk. Lost ~20lbs in 10 weeks.

coffeebeqn 3y ago
Are these a magic pill or are there bad side effects?
- petesergeant 3y ago
  Basically a magic pill (well, injection). Some mild nausea and indigestion at first, but nothing ginger tea and some over-the-counter antacids couldn't handle. Some people get severe nausea, and have to stop taking them. Only real issue at the moment is the high cost: $1k/month in the US, $500 rest-of-the-world, or cheaper in countries that subsidise them.
  - Scoundreller 3y ago
    > well, injection While I haven't any evidence about Tirzepatide in oral form, the results for semaglutide oral is pretty good. Haven't seen any oral vs injectable head-to-head studies of the same molecule though (funny how that is).
    - petesergeant 3y ago
      Sure, but it’s a PITA to take because absorption is bad. Take it on an empty stomach with exactly the right amount of liquid, and then nothing else in your stomach for 40m, and the gastrointestinal side effects are worse. I’m looking into using this for maintenance as I’ll be travelling a lot, but it’s much more of a hassle than the self-injecting needles
      - Scoundreller 3y ago
        > Sure, but it’s a PITA to take because absorption is bad. That’s a dosing problem :) Unsure if the GI effects will actually worse. Depends if it’s a direct effect or not.
- j4yav 3y ago
  I had to stop taking it because it increased my resting heart rate by about 25 bpm.
- BryanLegend 3y ago
  They're modified hormones. Normal glutide made by the body has a 5 minute half life and makes you feel full. Semaglutide has a 1 week half life.
- randcraw 3y ago
  5-10% of those taking GLP-1 agonists discontinue treatment citing nausea, diarrhea, indigestion, vomiting, and abdominal pain. Patients often must change not just how much they eat but what they eat, especially, reducing fat intake, eating smaller meals, and staying active right after eating. "What are the gastrointestinal adverse effects of the glucagon-like peptide 1 receptor agonists, and how should they be managed?" https://illinoisadvance.com/what-are-gastrointestinal-adverse-effects-glucagon-peptide-1-receptor-agonists-and-how-should-they-be-managed/ https://illinoisadvance.com/what-are-gastrointestinal-advers... "Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss" https://jamanetwork.com/journals/jama/fullarticle/2810542 https://jamanetwork.com/journals/jama/fullarticle/2810542
- vl 3y ago
  The main bad side effect is that you need to be really conscious about food. It’s easy to eat not enough or not to eat at all. Then unavoidably you feel really weak and metabolism slows down. You need to be really conscious to eat enough healthy foods, especially if you want to exercise.
- vrc 3y ago
  If you’ve ever had pancreatitis you can’t take this (me) because it increases overall risk of having an episode. If you’re unlucky like me and have a predisposition for pancreatitis or gallbladder issues, this can push you over the edge into the worst pain of your life and possible life threatening complications. But the percentage of folks at risk is relatively low so this is not a concern for most. Heavy alcohol consumption is a leading cause of pancreatitis so for folks with AUD and diabetes, if this cuts down both diabetes and the causal factor (drinking), maybe it’s a net positive if they’ve never had pancreatitis before. Unfortunately severe pancreatitis increases the risk of Type 2 and 3 diabetes and unfortunately this great treatment won’t be available.

isoprophlex 3y ago

> Recently, attention has turned to the possibility that semaglutide may have broader applications, including its potential impact on addictive behaviors such as reducing drug craving and alcohol consumption. Makes sense when your consider over-eating as addictive behavior. Considering there is a strong correlation between psychological trauma and addictive behavior as a coping mechanism, I wonder what happens to such people on Semaglutide. Will they find alternative coping mechanisms? Or does the physiological effect of of Semaglutide somehow soften the impact of the trauma underlying addictive behaviors? If these drugs cure trauma-derived addictive behaviors, that's just so extremely interesting, mechanistically. Really curious to know if this is true, and if we'll ever find out in which direction the causality goes.

BryanLegend 3y ago
They're modified hormones. Normal glutide made by the body has a 5 minute half life and makes you feel full. Semaglutide has a 1 week half life. It's amazing how much hormones control our minds.
- Scoundreller 3y ago
  If we're measuring the duration of effect of hormones, shouldn't we measure the duration of whatever it signals/triggers the action of or release of, rather than the molecule/peptide itself? If whatever it signals has a shorter half-life, then yeah, the duration of effect is going to depend on the hormone's half life, but not if whatever it signals has a longer half-life of effect.
amatic 3y ago
> If these drugs cure trauma-derived addictive behaviors, that's just so extremely interesting, mechanistically. So much this. I think going off semaglutide makes the weight come back, so it would seem that semaglutide doesn't change the circuits of trauma and addiction permanently, but it does something to them. The theory that obesity is a result of food addiction is pretty revolutionary, and now having alcoholism confirmed to respond to the same drug really supports the theory. Additionaly, if both are caused by childhood or development traumas, that opens other treatment options, and maybe some forms of change in how we as a society look at addictions. But maybe I'm going too far.

steezeburger 3y ago

Just hit the mega baader-meinhof occurrence. I just learned about this peptide this morning. Clicked the link and it's a paper from my alma mater. Lead author and I share a first name. I'm 4 years sober. Fun coincidences!

deleted 3y ago

[deleted]

addisonj 3y ago

This is pretty interesting, but for anyone who is on semaglutide maybe not a huge surprise? At least in my experience with semaglutide, everything I consume I need less of and I feel way less desire for things. I am not a big sweet eater, but usually enjoy a decent sized chunk of dark chocolate about every other day. I still have roughly the same cadence of wanting a piece, but the difference now a single square is enough and I don't feel the need for more. It isn't like the desire for things like sugar, fat, etc is gone, it is more like I am just wayyy better at knowing how much of that I need. I have been on semaglutide for ~2 months and it has honestly been wonderful for me. I have described it as being the drug that helps my brain stop acting like we live in times of famine and has massively improved my relationship with food. It really is just a shame that it is so cost prohibitive as I genuinely think that it probably could do a ton to reduce healthcare and impact of food overproduction (I eat so much less meat and I have heard some from others), but I don't think that will happen unless insurance starts covering it

jdmoreira 3y ago
I've never tried it. Can I ask a follow up question? Do you feel less need of other "wants" as well? money, ambition, power, sex drive? Things in this vein. Sorry if I'm being awkward but I'm genuinely curious.
- vl 3y ago
  No, it’s only food-related. Basically you feel hunger less. It’s easier to implement good diet. Obviously you need to eat healthy to get benefits from semiglutide.
  - seper8 3y ago
    Obviously you dont. Just the reduction of caloric intake and as a result, a reduction in body fat, is gonna lead to health benefits.
    - vl 3y ago
      I’m taking it, and it’s still trivial to overeat with calorie-dense food. It’s just easier to control impulse to do so.

dclowd9901 3y ago

> Semaglutide has made headlines recently as an FDA-approved drug for the treatment of diabetes under the name Ozempic, and weight loss under the name Wegovy. Given the only commonality between these two conditions, it almost seems like semaglutide is a synthetic version of the “you’ve had enough” protein.

pjerem 3y ago
I think we know that it’s exactly that. I have no source to cite but I’m pretty sure I read this somewhere.
- krisoft 3y ago
  Absolutely. I recommend the references linked under “Mechanism of Action” of the wikipedia page: https://en.m.wikipedia.org/wiki/Semaglutide https://en.m.wikipedia.org/wiki/Semaglutide
krisoft 3y ago
Yes, that is exactly what it is. It is designed to mimick the action of the naturally occuring GLP-1 hormone. It is one part of the “you have just eaten” molecular signaling chain.

palemoonale 3y ago

[flagged]

baq 3y ago
Ozempic is a brand name for this. Some other names are Wegovy and Saxenda.
- vl 3y ago
  Saxenda is liragludtide, which is similar, but different compound. Another brand name for semiglutide is Rybelsus - semiglutide in the tablet form to be taken daily.
- palemoonale 3y ago
  I know! But people might be more interested / attentive when a brand is included compared to just $randommoleculecombotheyneverheardabout...

ehPReth 3y ago

man, I wish I could afford this. Insurance (in Canada) caps out at like $800/y for reimbursement and the cost is something like $1k/month :(

vl 3y ago
Looks like Rybelsus (semiglutide in pill form) is $300 in Canada.
- ehPReth 3y ago
  oh interesting, thanks! I'll look into this
ehPReth 3y ago
sorry, can't edit this: but that's my (quite bad) insurance. not all insurance :)

FreeTrade 3y ago

I've long suspected that some excess alcohol consumption is a disguised form of overeating. It's socially acceptable for men to have a few beers in a way that it's not acceptable for them to have a few icecreams. I can well see semaglutide having a similar affect on that kind of use. But I wonder does it have the same effect on people drinking mainly to change their mental space.

aaron695 3y ago

[dead]