GLP-1 agonists in addiction therapy – review

Substance use disorders (SUDs) represent a major global public health challenge, and currently available pharmacological treatments remain only moderately effective. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used in the treatment of obesity and type 2 diabetes, have recently attracted attention as potential therapeutic agents in addiction medicine due to their effects on reward-related neural pathways. The aim of this review was to evaluate the efficacy and safety of GLP-1RAs in adults with substance use disorders. A total of nine studies met the inclusion criteria and were included in the qualitative analysis. The available evidence suggests that semaglutide and exenatide may reduce alcohol consumption, decrease craving, and support the maintenance of nicotine abstinence, while also contributing to weight control. In contrast, clinical data regarding stimulant use disorders remain limited. Across the analysed studies, GLP-1RAs demonstrated a favourable safety profile. The most commonly reported adverse effects were mild gastrointestinal symptoms, and no significant neuropsychiatric safety concerns were identified. Overall, GLP-1RAs may represent a promising adjunctive approach in the treatment of substance use disorders. However, potential plateau effects and rebound phenomena after treatment discontinuation suggest that long-term therapeutic strategies may be required. Further large-scale randomized clinical trials are needed to confirm these findings and to determine the optimal role of GLP-1RAs in addiction treatment.