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

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.