A recent case study has highlighted the potential of semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, as a novel treatment for patients suffering from both obesity and cocaine addiction. This case, published in the Journal of Medical Case Reports, centers on a 54-year-old male patient with a 15-year history of cocaine abuse and a BMI of 35.4, classifying him as obese. Despite attempts at weight loss and addiction treatments, the patient struggled with sustained results. The case suggests that semaglutide, typically used to manage type 2 diabetes and obesity, may also serve as a dual-action therapy that targets both the metabolic and neurological factors involved in these complex conditions.
Semaglutide works by stimulating GLP-1 receptors, which regulate insulin secretion, gastric emptying, and satiety, alongside its possible impact on reward pathways in the brain. These pathways, which involve areas such as the nucleus accumbens and ventral tegmental area, are critical in both food intake and addictive behaviors. Previous studies have shown that GLP-1 receptor agonists can reduce cravings for addictive substances, including cocaine and alcohol. In this patient, the 12-week semaglutide treatment not only led to a significant 13 kg weight loss but also resulted in a 59% reduction in cocaine cravings, as measured by the Cocaine Craving Questionnaire-Brief.
This promising outcome underscores the possibility of utilizing semaglutide as a therapeutic approach for individuals who struggle with the overlapping challenges of obesity and substance use disorders. The patient experienced no serious adverse effects, though mild gastrointestinal issues were noted during the early stages of treatment. Importantly, the patient's psychological health also improved, with reductions in anxiety and depressive symptoms, likely linked to both weight loss and the decrease in cocaine cravings.
While the results of this case are encouraging, it remains a preliminary observation, and further studies are necessary to confirm the long-term efficacy and safety of semaglutide in this context. Future research should aim to explore the mechanisms behind its effects on addiction and examine whether combining semaglutide with behavioral therapies could enhance treatment outcomes.
For more detailed information, you can access the full article here: https://doi.org/10.1186/s13256-025-05049-w
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