GLP-1 Receptor Agonists and Alcohol Use Disorder: Promise for a New Treatment Approach

The role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) as effective glucose-lowering and nephroprotective agents in type 2 diabetes is well established. Their emergence as treatments for obesity is considerably more recent. In the short time since this indication was approved, these medications have attracted considerable attention, and their use in clinical practise has expanded rapidly. Amid this rapid expansion, clinicians have encountered growing anecdotal reports from patients taking GLP-1RAs describing unexpected improvements in substance use behaviours. Such reports are consistent with a growing body of preclinical evidence demonstrating that GLP-1RAs reduce intake of alcohol and other addictive substances. Whether preclinical observations can be replicated in human studies is currently being tested in clinical trials. One prevailing hypothesis suggests that glucagon-like peptide-1 (GLP-1) exerts its effects via central mechanisms, including, at least in part, modulation of dopamine transmission. Studies imply that activation of central glucagon-like peptide -1 receptors (GLP-1Rs) functionally regulates the mesolimbic reward pathway and reduces addiction-like behaviors in rodent models. This narrative review summarizes the existing evidence regarding the effects of GLP-1RAs on alcohol consumption. Relevant studies published between January 2015 and March 2026 were identified via literature search. Collectively, the evidence supporting GLP-1RAs for the treatment of AUD is promising yet inconsistent, with randomized clinical trials yielding mixed results for the primary outcome of reduced alcohol consumption. Although current findings do not justify changes to clinical practice, they point toward potential benefits of GLP-1RAs, extending beyond glycemic and weight control, particularly among patients with AUD.