From the Department of Psychiatry, Brigham and Women's Hospital, Boston, MA (MRS, KO-B, JS); Harvard Medical School, Boston, MA (MRS, KO-B, LMH, JS); and Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA (LMH).
J Addict Med. 2024;18(5):488-498. doi: 10.1097/ADM.0000000000001347. Epub 2024 Aug 1.
Substance use disorder (SUD) continues to be a leading cause of morbidity and mortality with limited treatments. There is interest in expanding the use of GLP-1 agonists in treating SUD. However, evidence for safety and efficacy in humans is limited. This review aims to bridge the existing knowledge gap by establishing a baseline of literature in this area to inform future trials and clinical practice. Our inclusion criteria were English peer-reviewed manuscripts reporting on use of GLP-1, GIP, and/or glucagon receptor agonists in treatment of SUDs, excluding case studies. The literature search was performed in accordance to PRISMA guidelines. Five studies were included in this review examining the use of this medication in tobacco use disorder, alcohol use disorder, and cocaine use disorder. No studies regarding substance withdrawal syndrome were identified. The included studies varied widely in terms of patient selection, dose/formulation of GLP-1 agonists, and follow-up. The results of this scoping review are mixed, with 3 studies demonstrating positive results and 2 studies finding no efficacy of this medication on SUD outcomes. It is premature to prescribe this medication off-label to patients. Further research is needed to determine the efficacy of GLP-1 agonists in treating SUD.
物质使用障碍（SUD）仍然是导致发病率和死亡率的主要原因，而治疗方法有限。人们对扩大 GLP-1 激动剂在治疗 SUD 中的应用感兴趣。然而，人类安全性和疗效的证据有限。本综述旨在通过建立该领域的文献基线来填补现有知识空白，为未来的试验和临床实践提供信息。我们的纳入标准是英语同行评议的手稿，报告了 GLP-1、GIP 和/或胰高血糖素受体激动剂在治疗 SUD 中的使用，不包括病例研究。文献检索符合 PRISMA 指南。本综述共纳入了 5 项研究，研究了该药物在烟草使用障碍、酒精使用障碍和可卡因使用障碍中的应用。没有发现关于物质戒断综合征的研究。纳入的研究在患者选择、GLP-1 激动剂的剂量/配方和随访方面差异很大。这篇范围综述的结果喜忧参半，有 3 项研究显示出积极的结果，有 2 项研究发现这种药物对 SUD 结果没有疗效。现在就给患者开这种药物的处方还为时过早。需要进一步研究以确定 GLP-1 激动剂在治疗 SUD 中的疗效。
