Volume 30, Issue 169, March 2026

Glucagon-Like Peptide-1 Receptor Agonist potential in AUD treatment. Neurobiological Mechanisms and Clinical Evidence

Paulina Wądołowska^♦, Patryk Pindlowski, Ewelina Komorowska, Jakub Szyszkowski, Zuzanna Zgrzywa, Brygida Tucka, Natalia Kriese, Izabela Zawadzka, Bartłomiej Kowalski, Jakub Jaworski

Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

^♦Corresponding author
Paulina Wądołowska, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

ABSTRACT

Alcohol Use Disorder (AUD) constitutes a significant global health challenge, with standard pharmacological treatments constrained by limited long-term efficacy and poor patient adherence. Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs), originally used in the management of diabetes, have recently been identified as potential treatment for AUD due to their influence on the gut-brain axis and mesolimbic reward circuit. This review synthesizes evidence from a systematic search of PubMed and Scopus (January 2010 to July 2025), with emphasis on contemporary GLP-1 RAs such as Semaglutide, Liraglutide, and Exenatide. Preclinical studies consistently show that GLP-1 RAs reduce alcohol intake, motivation, and relapse-like behaviors in animal models by modulating dopaminergic signalling in the structures of the reward system. Cohorts and early randomized clinical trials provide indications that GLP-1 RAs treatment results in a reduction in the prevalence of Heavy Drinking Days and craving, potentially induced by the cross-reward effect. Although the safety profile appears favorable, most of the evidence comes from retrospective data and pilot studies. In summary, GLP-1 RAs are a promising intervention for AUD. However, there is still a requirement for large-scale randomized controlled trials with standardized abstinence endpoints to establish their efficacy and future clinical utility.

Keywords: Alcohol Use Disorder, Addiction, Reward circuit, Semaglutide, GLP-1 Receptor agonist, Craving

Medical Science, 2026, 30, e49ms3791

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DOI: https://doi.org/10.54905/disssi.v30i169.e49ms3791

Published: 07 March 2026