GLP-1 and cravings: what the evidence shows

Medicines acting on the GLP-1 pathway were developed for metabolic disease. Tirzepatide, one of the two named components of AntiHEDON-X, has its established evidence base in the treatment of obesity (Jastreboff et al., N Engl J Med 2022). That trial programme studied weight, not addiction - and this page keeps the two separate.

The craving signal

Quddos et al. (Sci Rep 2023) combined a machine-learning analysis of about 68,250 Reddit posts with a remote study of 153 adults with obesity: participants taking semaglutide or tirzepatide self-reported lower alcohol intake, fewer drinks per drinking episode and lower AUDIT scores than before starting medication and than controls. This is self-reported, observational evidence.

Wang, Volkow and colleagues (Nat Commun 2024) examined real-world population data and reported associations between semaglutide use and both the incidence and the recurrence of alcohol use disorder diagnoses.

The first randomized trial

Hendershot et al. (JAMA Psychiatry 2025) randomized 48 adults with alcohol use disorder to nine weeks of once-weekly low-dose semaglutide or placebo (ClinicalTrials.gov NCT05520775). Semaglutide reduced the alcohol consumed in a laboratory self-administration task, drinks per drinking day and weekly craving; it did not significantly change average drinks per calendar day. The authors describe the findings as initial evidence justifying larger trials - one small, short phase 2 study, not a settled answer.

What the evidence does not show

No GLP-1 medicine carried an approved addiction indication in the sources searched. Searched: PubMed, 2026-09-10 (semaglutide and tirzepatide against alcohol use disorder, craving and nicotine terms). Not searched: FDA, EMA and MHRA label databases, ClinicalTrials.gov registration states, non-English regulatory registries. That means none identified in this search - not that none exists. Whether craving reduction is a direct reward effect or rides on appetite and nausea remains an open mechanistic question.

Where Selank stands

Selank, the second named component of AntiHEDON-X, has a predominantly Russian-language published evidence base. This page does not summarise that literature; a dedicated full review is owed before any claim is made here.

References

  • Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022. PubMed 35658024
  • Quddos F, Hubshman Z, Tegge A, et al. Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity. Sci Rep. 2023. PubMed 38017205
  • Wang W, Volkow ND, Berger NA, Davis PB, Kaelber DC, et al. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population. Nat Commun. 2024. PubMed 38806481
  • Hendershot CS, Bremmer MP, Paladino MB, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025. PubMed 39937469

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