당뇨병 치료제 오젬픽(Ozempic)을 투약했을 때 체중 감량 효과뿐 아니라 술이나 담배의 중독 증상까지 완화할 수 있다는 가능성이 제시됐다. 일부 연구진은 이 약물을 이용해 펜타닐 복용 등 마약 중독을 치료할 수 있는지 연구하고 있다.
CNN방송은 최근 세마글루티드(Semaglutide)를 성분으로 하는 약물 오젬픽이 당뇨병과 비만 치료뿐 아니라 사람의 중독 행동을 억제하는 데 도움을 줄 수 있다고 보도했다. 그러면서 체리 퍼거슨이라는 여성의 사례를 소개했다.
퍼거슨은 11주 전부터 오젬픽을 투여했다고 한다. 그는 코로나19 대유행 시기 체중이 50파운드(약 22.6㎏) 늘자 당뇨 전조 증상이 나타났고, 살을 뺄 목적에서 이 약물을 투여한 것이다. 오젬픽은 최근 미국에서 공급 대란이 벌어질 정도로 인기다.
퍼거슨은 오젬픽 투약 이후 38파운드(약 17㎏)를 뺐다. 하지만 예상치 못한 효과도 덤으로 얻었다고 한다. 그는 "수년간 펴왔던 전자담배와 연초가 더는 끌리지 않는다"며 "매우 이상한 기분"이라고 말했다고 CNN은 전했다.
퍼거슨은 자신이 술을 덜 마시게 됐다는 것도 알아챘다. 술집에서 축구 경기를 보면 여러 잔의 맥주를 마시던 그였지만, 이제는 한 잔으로도 만족한다고 했다.
퍼거슨과 유사한 사례는 여러 차례 보고됐다. 오젬픽 같은 성분(세마글루티드)의 유사 약물을 투약한 후 중독 증상이 완화됐다는 것이다.
이와 관련 펜실베이니아 대학의 체중 및 섭식 장애 센터는 세마글루티드 성분이 장기적으로 식욕 등 욕구에 어떤 영향을 미치는지 알아보는 연구를 진행하고 있다.
미국 국립보건원(NIH)은 실제 설치류에 세마글루티드를 투약하자 알코올 섭취가 감소했다는 연구 결과를 내놨다.
연구를 진행한 로렌조 레지오 박사는 "GLP-1 유사체인 세마글루티드 같은 약물은 장뿐만 아니라 뇌에도 영향을 미친다"며 "뇌의 신경 전달 물질인 도파민 분비에 영향을 미치면서 술의 보상 효과를 줄여 결국 음주를 덜 하게 만드는 원리"라고 설명했다.
NIH은 술과 담배에서 나아가 세마글루티드의 마약 중독 완화 효과도 연구하고 있다. 최근 미국에서 심각한 사회 문제로 떠오른 '펜타닐' 중독을 세마글루티드로 해결할 수 있을지 알아보는 것이다.
다만 이런 원리를 이용해 중독 완화 약물을 만들려면 더 많은 연구가 필요하다. 오젬픽을 개발한 제약사인 노보노디스크에서는 관련 연구를 진행하지 않는 것으로 알려졌다. 알코올 중독 치료 등에 대한 약물의 수익성이 높지 않기 때문인 것으로 보인다.
Weight-loss meds like Ozempic may help curb addictive behaviors, but drugmakers aren’t running trials to find out
One day seven weeks ago, “I thought, ‘you’re doing something about your weight; leave your vape at home,’ ” Ferguson said.
She hasn’t picked it back up since, she says.
Ferguson is one of many people taking Ozempic and similar drugs for weight loss who say they’ve also noticed an effect on their interest in addictive behaviors like smoking and alcohol.
A smoker for most of her life, Ferguson started Ozempic 11 weeks ago to try to lose about 50 pounds she’d gained during the Covid-19 pandemic, which had made her prediabetic.
She’d switched from cigarettes to vaping last summer in hopes of quitting but found vapes to be even more addictive. That changed, she said, once she started Ozempic.
“It’s like someone’s just come along and switched the light on, and you can see the room for what it is,” Ferguson said. “And all of these vapes and cigarettes that you’ve had over the years, they don’t look attractive anymore. It’s very, very strange. Very strange.”
Ferguson said she drinks less alcohol on Ozempic, too. Whereas she would have had multiple drinks in a pub while watching a football match in Buckinghamshire, UK, she’s now content with just one.
Some doctors say that when it comes to addictive behaviors, an effect on alcohol use is the most common thing they hear from people taking Ozempic or similar medicines.
“I have had a number of patients sort of describe that and ask about it because they’re curious about, you know, ‘hey, I’ve noticed this change; could that be due to this medication?’ ” said Jena Shaw Tronieri, an assistant professor of psychiatry and director of clinical services at the Center for Weight and Eating Disorders at the University of Pennsylvania’s Perelman School of Medicine.
Tronieri is running a clinical trial of semaglutide (the generic name for Ozempic – which is approved for diabetes – and Wegovy – approved for weight loss) to better understand its long-term effects on appetite. In many lifestyle modification trials she’s run, she’s never had participants report this kind of feeling about alcohol.
But with semaglutide, “people sort of describe, ‘You know what, I’m just not really interested in that anymore. I don’t feel like drinking,’” she said.
And when they ask whether it could be the drug, she tells them that there isn’t evidence to say so with certainty, “but there is some reason to believe that that could be one of the effects.”
Dr. Lorenzo Leggio is studying this issue at the National Institutes of Health. He and a team of researchers just published a study showing that semaglutide reduces alcohol drinking in rodents.
Drugs like semaglutide, in a class known as GLP-1 analogues, may influence interest in things like alcohol because they have an effect not just in the gut but in the brain, Leggio said.
“We believe that at least one of the mechanisms of how these drugs reduce alcohol drinking is by reducing the rewarding effects of alcohol, such as those related to a neurotransmitter in our brain, which is dopamine,” he said. “So these medications are likely to make alcohol less rewarding.”
Their impact could go beyond alcohol and smoking; Leggio said his team is also studying whether semaglutide has an effect on fentanyl-use disorder. And the Atlantic recently reported that people taking Ozempic have said it’s helped them stop addictive behaviors like nail-biting and online shopping.
“There is a lot of overlap in the neurobiological mechanisms that regulate addictive behaviors in general,” Leggio said. “So it’s possible that medications like semaglutide, by acting on this specific mechanism in the brain, they may help people with a variety of addictive behaviors.”
More research needs to be done, particularly human clinical trials, to prove that semaglutide and similar medicines have this effect, he said.
But there aren’t many underway. One set, looking at semaglutide’s effect on alcohol and cigarette use, is being run out of the University of North Carolina.
“We don’t yet have the clinical data necessary to draw conclusions,” Christian Hendershot, an associate professor in the Department of Psychiatry and the Bowles Center for Alcohol Studies at UNC Chapel Hill, who’s running the trials, wrote in an email to CNN. “It does seem very clear from people reaching out about our trials (in particular several treatment providers) that many patients are experiencing some significant secondary benefits from being on these treatments.
“To see this extent of anecdotal clinical data emerging prior to any human work being published,” he added, “is a relatively unprecedented situation.”
Novo Nordisk, which makes Ozempic and Wegovy, and Eli Lilly, which makes a similar drug called Mounjaro, said they aren’t currently studying these drugs for addiction.
“They have their hands full with obesity and related metabolic disease,” said Evan Seigerman, a pharmaceutical industry analyst who follows the companies for financial firm BMO Capital Markets.
And addiction drugs, particularly for alcohol-use disorder, haven’t been a particularly profitable market for drug companies, despite a large need. More than 29 million Americans had alcohol-use disorder in 2021, according to the National Institute on Alcohol Abuse and Alcoholism, but less than 5% receive drug therapy, research from financial firm TD Cowen found.
Available drugs like Vivitrol didn’t see major use when they reached the market as physicians may not have been familiar with treating alcohol dependence with medicines, Cowen said. Another drug, Antabuse, is a pill that makes people feel terrible if they drink alcohol while they’re on it. Compliance is a problem, Cowen’s research shows, because people can just stop taking it if they want to drink.
“U.S. Antabuse sales,” Cowen’s analysts wrote, “are negligible.”
Leggio said he was disappointed but not surprised to hear that pharmaceutical companies weren’t studying GLP-1 drugs for addiction, adding that a lack of drug industry-sponsored trials for addiction treatments are a notable problem for the field.
But trials are what will be needed to prove that the experiences reported by Ferguson and many others are true effects of the medicines.
Ferguson said she’s lost 38 pounds since starting Ozempic. But more important to her, she said, is how the drug has helped quiet constant thoughts about food, vaping or alcohol.
“If I knew I would be feeling this way, I probably would have done this a year ago when I first started struggling” with weight gain, Ferguson said. “The weight that it takes off your mind is far greater than any pounds that can come off your body.”