Ozempic, a form of the drug semaglutide, was originally approved for type 2 diabetes in 2017.
People quickly realized it's also good for weight loss, largely because of how it works on the brain.
Scientists are now investigating other uses for the drug, from Alzheimer's treatment to addiction.
Since 2017, the injectable prescription drug Ozempic has been used by type 2 diabetics across the US to help manage their blood sugar. But right from the start, it became apparent that the medicine — generically called semaglutide — was doing more than controlling diabetes.
That's because this drug mimics a hunger-regulating hormone called GLP-1 that our bodies produce naturally – and that hormone doesn't just regulate blood sugar. It also tells our brains to be satisfied with less food, slows down digestion, and can even change what specific foods a person likes.
As a result of these attributes, people quickly started taking Ozempic off-label for weight loss, and soon a higher-dose version of semaglutide, Wegovy, was approved by the FDA for weight loss in overweight and obese patients.
But scientists have recently started to realize that semaglutide might do even more than regulate hunger and blood sugar.
From addiction to Alzheimer's disease, here are some of the major conditions semaglutide could treat next:
Semaglutide could be a powerful tool to fight addiction
Scientists suspect the same traits that allow semaglutide to work on the brain's reward system to make people less interested in food could also be harnessed to help people give up addictions to cigarettes, alcohol, and other vices.
Scientists have already studied how lab mice taking other GLP-1 drugs are better able say no to cocaine. Researchers are pretty sure that's because GLP-1 drugs are essentially breaking key addiction cycles in the mouse brain.
"Based on what we know about GLP-1, it does make some sense," Novo Nordisk's Executive Vice President of Development, Martin Lange, told Insider.
Semaglutide, he said, like other GLP-1 drugs, acts on areas of the brain that control food cravings, leading people to eat less.
"I think it's fair to speculate that you could have similar effects on craving for tobacco or craving for alcohol," he said.
Scientists are also studying whether semaglutide could treat liver disease
Scientists are studying whether semaglutide, which can change the way the liver produces sugar, could also improve liver damage in a specific kind of non-alcoholic liver inflammation called NASH.
A worldwide trial by Ozempic manufacturer Novo Nordisk is recruiting patients in more than 20 countries including the US and UK for a large phase 2 trial. For this research, semaglutide is being paired with a new liver medication, to see if taking the two together works better than trying either drug alone. A smaller trial already completed by Novo Nordisk found that NASH patients who tried semaglutide were more likely to heal their livers, especially if they were treated early.
It could be reducing the risk of heart attacks and strokes in patients who take it
But over time studies have suggested the opposite — semaglutide may actually reduce the risk of heart attack and stroke among overweight and diabetic patients. One large study of over 3,000 type 2 diabetes patients in the New England Journal of Medicine suggested that taking the drug reduced the risk of heart issues by about 26% in type 2 diabetic patients.
Weight loss, improvements in blood pressure, and better blood sugar control could all be part of the reason why heart health appears to improve in patients who take semaglutide.
It's still unclear what effect the heart rate increases associated with semaglutide might have on any non-diabetic, non-overweight people who take the drug; large-scale studies of that question haven't been done.
There's a theory that it could be used to treat depression
There's hope that perhaps semaglutide could be used to treat major depressive disorder, because of the unique ways it can impact thinking and cognition. A small phase 2 study of 60 patients is underway in Toronto to test the theory.
And while semaglutide isn't suspected of being a treatment for schizophrenia on its own, it is being tried out in some patients who are already being treated with anti-psychotic drugs, which often lead to weight gain. The idea is that pairing anti-psychotics with semaglutide could help many schizophrenic patients maintain a more healthy weight. It could also make fatal heart issues, which may be more common in people with schizophrenia due to obesity, less likely.
Or prevent cancer, by revving up cancer-killing cells
Scientists have long known that people who are overweight and obese are at higher risk of developing many different kinds of cancer. One reason this is true is because their stores of cancer-annihilating "natural killer" cells don't work as well as they do in other people.
Semaglutide seems to help with this problem.
The research is still preliminary, but one recent study of 20 obese people in Ireland found that semaglutide improved their natural killer cell metabolism and function — regardless of how much weight they lost on the drug. This initial data suggests there is something about the drug semaglutide itself that is helping rev up anti-cancer cells in obese people who try it out.
The drug is being studied in patients with early-onset Alzheimer's
Many diabetes drugs – old and new – have been suspected of having the potential to help out with this incurable brain disease, because of the complicated ways anti-diabetic compounds can improve inflammation and regulate metabolism. In mice, researchers have found semaglutide can decrease Alzheimer's-related brain inflammation.
Scientists are also hopeful that the drug may improve how critical pathways in the brains of Alzheimer's patients – pathways related to memory and learning – function.
"We know that GLP-1 improves what we call synaptic plasticity in the brain," Lange said. "Two years from now, we will have the answer to the question of whether GLP-1 may have a role in treatment of mild cognitive impairment and early dementia."
And it could possibly delay aging itself
There's also some suspicion that GLP-1 drugs like Ozempic can improve age-related issues more generally, tamping down chronic inflammation, stimulating the growth of new neurons in the brain, and improving some of the major risk factors for age-associated diseases and decline.
But it's still early days for the idea, and there are no human trials yet to answer the question.
Read the original article on Insider