GLP-1 agonists may be able to treat addiction, prevent Alzheimer’s, and more.
KEY TAKEAWAYS
- GLP-1 agonists make it easier to lose weight by mimicking a hormone our bodies release naturally after we start eating.
- Evidence is mounting that they could treat other health issues, including ones that aren’t obviously related to weight.
- Though the research is still in the early stages, some studies have suggested the drugs could help patients with infertility, sleep apnea, Parkinson’s, and Alzheimer’s.
If the COVID-19 vaccines were the most significant FDA approvals of the 2020s so far, GLP-1 agonists to treat obesity are a strong runner up.
Though these drugs have been used to treat type 2 diabetes for nearly two decades, it wasn’t until 2021 that the FDA approved one of them — Novo Nordisk’s Wegovy (semaglutide) — as a treatment for obesity. Clinical trials showed that people lost 10-20% of their body weight.
This was huge. An estimated 42% of adults in America are classified as obese, which puts them at increased risk of many serious health issues, including heart disease and some cancers, and death. The standard prescriptions prior to this — diet changes and exercise — are notoriously hard for many people to implement and stick to.
GLP-1 agonists make it easier to lose weight by mimicking a hormone our bodies release naturally about 15 minutes after we start eating — this reduces our appetite and triggers the release of insulin, which helps take sugar out of our blood and convert it into energy.
In addition to helping people shed pounds, some GLP-1 agonists also have a proven ability to reduce weight-related health issues, such as heart attacks and deaths from cardiovascular disease. In clinical trials, people on the drugs ended up with lower blood pressure, blood sugar, and cholesterol, and some studies suggest the meds could treat fatty liver disease, too.
But evidence is mounting that they could treat other health issues — including ones that aren’t obviously related to weight. Researchers are now taking a closer look at these other potential indications for GLP-1 agonists. Here’s what they’re finding out.
Parkinson’s disease
Parkinson’s is a neurodegenerative disorder caused by the death of specific neurons in the brain. This causes problems with movement, mental and behavioral changes, and often premature death. While existing treatments can help control symptoms, none can stop the disease from progressing.
For a recent phase 2 trial, French researchers gave 156 people in the early stages of Parkinson’s a GLP-1 agonist (lixisenatide) or placebo every day for 1 year. Compared to at the start of the trial, the motor symptoms of people in the placebo group were slightly worse by the end of the year, while the treatment group’s motor symptoms remained essentially the same.
It’s not clear why this is happening — it may have something to do with the known but not well-understood connection between Parkinson’s and diabetes. This was a fairly small study and a lot of questions remain to be answered, including whether GLP-1 agonists could help people with more advanced Parkinson’s, halt the progression of Parkinson’s motor symptoms over a longer period, or prevent other types of symptoms, such as ones related to cognition, from worsening.
Still, with up to one million Americans affected by Parkinson’s, these results are highly encouraging, and the results of a larger phase 3 trial testing another GLP-1 agonist (exenatide) as a Parkinson’s treatment are expected in 2024.
Drug and alcohol addiction
Some people taking GLP-1 agonists for weight loss or diabetes have reported an unexpected, but often welcome side effect: decreased cravings for drugs, alcohol, and tobacco.
“GLP-1 receptors are located in the areas of the brain associated with both food and drug reinforcement,” Dr. Luba Yammine, associate professor of psychiatry at UTHealth Houston, told Freethink. “Additionally, brain mechanisms that contribute to overeating overlap with those that facilitate drug seeking behaviors. It is plausible that GLP-1 agonists could decrease reward (i.e., pleasure) and cravings for addictive substances.”
Plausible, but not confirmed. Several animals studies have found that GLP-1 agonists can reduce drug and alcohol seeking behavior, but there isn’t strong data from human trials: one small trial found that GLP-1 agonists could reduce opioid cravings, for example, while another found they could reduce cravings for alcohol, but only in people who were living with obesity.
Trials are ongoing, though. The National Institute on Drug Abuse is sponsoring one focused on alcohol addiction, and Yammine is leading two trials in people who are addicted to nicotine.
“In both of our trials, we incorporate measures to assess not only whether GLP-1 agonists ‘work,’ but also examine how they work via interrogating the hypothesized mechanisms,” she told Freethink, adding that they anticipate having trial results in about 2-3 years.
Because drug and alcohol addiction are, like obesity, unfortunately common in the U.S., if GLP-1 agonists prove to be effective treatments for any of these substances, this is another area where the medications could have a huge impact…
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https://bigthink.com/health/glp-1-agonists/
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