People with type 2 diabetes were hospitalized less frequently for alcohol or substance use disorders while undergoing treatment with GLP-1 receptor agonists. This is shown by a large Swedish registry study involving the Central Institute of Mental Health (CIMH). For the first time, the researchers examined how the observed associations evolved after discontinuation of the medication. They found that the reduction in alcohol-related hospitalizations was still detectable for up to six months after the end of treatment, but was no longer evident after twelve months. The results were published in the journal The Lancet Psychiatry.
GLP-1 receptor agonists are among the active ingredients in so-called weight-loss injections. Originally developed to treat type 2 diabetes, they are now also used to treat severe obesity. In recent years, studies have provided evidence that they may also reduce the consumption of alcohol and other substances. However, it has not yet been clear whether these potential effects persist after discontinuing the medication.
Data from more than 167,000 people analyzed
For the current study, researchers—with the participation of the CIMH—analyzed health registry data from 167,026 people with type 2 diabetes in Sweden. This made the study one of the largest to date on this topic. The researchers compared periods during which the same individuals were treated with GLP-1 receptor agonists with periods during which they received no treatment. They also examined the first six months as well as the period between six and twelve months after discontinuing the medication.
Effects Not Statistically Significant After Treatment Ends
During treatment with GLP-1 receptor agonists, alcohol- and substance-related hospitalizations were less frequent than during treatment-free periods. For alcohol-related hospitalizations, this association remained statistically significant even during the first six months after treatment ended. However, in the period between six and twelve months after discontinuation, there was no longer any statistically significant evidence of the previously observed reduction in hospitalization rates. For substance-related hospitalizations, the researchers found no statistically significant associations after discontinuation, neither in the first six months nor in the period between six and twelve months.
Careful clinical follow-up recommended after treatment ends
“Until now, little was known about how the observed associations develop after treatment ends. Our results suggest that they do not persist and that they diminish within a year,” says Prof. Dr. Dr. Patrick Bach, research group leader at the Central Institute of Mental Health and lead author of the study. “The findings suggest that the potential effects of this class of drugs on addiction-related behaviors appear to be reversible.”
The researchers see the results as an indication that the period following the end of therapy warrants special attention. “The data underscore the importance of careful monitoring and follow-up of patients after the end of treatment with GLP-1 receptor agonists,” Bach emphasizes.
No Conclusions About Cause and Effect
The researchers point out that this is an observational study. The results therefore do not allow for any conclusions about cause and effect. Furthermore, the study included only people with type 2 diabetes. Further studies are needed to better understand the underlying mechanisms and the potential implications of these findings for the treatment of alcohol and substance use disorders.
Publication
Bach P, Franck J, Hällgren J et al. Association of GLP-1 receptor agonists with alcohol use disorder-related and substance use disorder-related hospital admissions during treatment and after discontinuation: a Swedish register-based within-individual observational study
The Lancet Psychiatry, 13, 669-677. DOI: 10.1016/S2215-0366(26)00172-0