Exenatide reduces Alcohol Cue Reactivity which is involved in Drug Reward and Addiction

Exenatide, a medication used to treat diabetes, has shown promising results in reducing alcohol cue reactivity in the brain, which is a crucial aspect of addiction, according to a clinical trial. The trial involved 127 treatment-seeking patients with alcohol use disorder (AUD) who were randomly assigned to receive either exenatide or a placebo for 26 weeks, in addition to cognitive-behavioral therapy.

Although the medication did not significantly reduce the number of heavy drinking days compared to the placebo, it did lower alcohol cue reactivity in areas of the brain that are involved in drug reward and addiction. The study also found that exenatide reduced heavy drinking days and total alcohol intake in obese patients, indicating that this medication may be more effective for certain subgroups of individuals with Alcohol Use Disorder (AUD).

AUD is a chronic, relapsing brain disorder that affects millions of people around the world. It is characterized by excessive alcohol consumption and a loss of control over drinking, leading to a range of physical, psychological, and social problems. AUD is a serious public health concern, accounting for 5% of deaths annually. Although there are several treatments available for AUD, there is still an urgent need to develop new therapies.

The clinical trial on exenatide provides new important knowledge on the effects of glucagon-like peptide-1 (GLP-1) receptor agonists, such as exenatide, as a novel treatment target in addiction. GLP-1 is a hormone that regulates appetite and glucose metabolism, and GLP-1 receptor agonists are commonly used to treat type 2 diabetes. Previous studies have shown that GLP-1 receptor agonists can reduce alcohol consumption in rodents and nonhuman primates, but their efficacy in patients with AUD was unknown until now.

Clinical trial

In the trial, treatment-seeking AUD patients were randomly assigned to receive exenatide or a placebo for 26 weeks, in addition to cognitive-behavioral therapy. The study found that exenatide did not significantly reduce the number of heavy drinking days compared to the placebo. However, exenatide did lower alcohol cue reactivity in areas of the brain which are crucial for drug reward and addiction. 

Exploratory analyses revealed that exenatide significantly reduced heavy drinking days and total alcohol intake in a subgroup of obese patients. This suggests that exenatide may be more effective for certain subgroups of individuals with AUD. Adverse events were mainly gastrointestinal, which is a common side effect of exenatide.

Conclusion

Overall, the study provides new important knowledge on the effects of GLP-1 receptor agonists as a novel treatment target in addiction. Although exenatide did not significantly reduce the number of heavy drinking days, it did reduce alcohol cue reactivity in the brain, which is a crucial aspect of addiction. The finding that exenatide may be more effective in obese patients is also noteworthy. Further research is needed to determine the long-term effects of exenatide on AUD and to identify other potential therapeutic targets for this serious public health concern.