Andrew Huberman· PhD
To me that seems more likely to change you know swallowing something a drink versus say injecting myself or snorting a powder and you know the most it's you know eating like behavior.
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To me that seems more likely to change you know swallowing something a drink versus say injecting myself or snorting a powder and you know the most it's you know eating like behavior.
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But still you I see this pattern particularly with simaglletide which is the GLP that is in uh wave and uh ompic and alcohol uh drops in alcohol use and so I'm and and the other thing I think is perhaps important and what why I'm I'm working now with the VA and Novo and and a philanthropist to to do something like this is that alcohol is the most like eating of of drug behaviors.
these individuals have tried almost everything to get their addiction under control and I would say more we have more experience with treatment refractory alcohol use disorder including trying medications right medications like bphen um medications like uh nxone medications I didn't know about backlin so tell me backlin the muscle relaxant is used to treat alcohol disorder yeah so there are more Placebo controlled trials in Europe than here in the US it's not FDA approved for that indication it's not first line for us but we will sometimes use back backlin sometimes you we'll use Gabapentin what doses of of backlin and Gabapentin are are necessary to produce that effect well Gabapentin we usually I I will say I I'm using less Gabapentin than I used to because we've been seeing people actually get physically dependent and some cases addicted to Gabapentin but typically we'll use the 600 milligrams three times a day to help people withdraw from alcohol and in some cases um maintenance although less of that I don't use backin often enough to tell you what the dose is I I have to look it up um but but those are those I would say more often we're using nxone the opioid receptor blocker which can be very nice because a many people's goal is moderation not just abstinence and Al Ton's been helped been shown to help not just with abstinence but also reducing drinks on drinking days so that's very nice we we use that almost as first line we use antibus dulam which is the one that's a deterrent if you drink on it you'll get sick people don't usually like to go to that first line but it works when people take it we use things like topy it should be pointed out that if patients do use that and drink through it they are actually increasing the toxicity of alcohol gram for gram because they're experiencing more acety alahh which is the obviously the toxic mediator yes exactly so you really have to be careful who you prescribe it to and it has to be somebody who can can really be committed to not drinking what once they've taken that medication um we also use Topiramate which is a seizure medication which was first first discovered off label to be helpful for binging disorder and um later was shown to be helpful for alcohol use disorder but the bottom line is when we have a case of a patient who has tried these various medications who's been involved in Alcoholics Anonymous who's tried Psychotherapy who's gone to rehab who's done it all um in that rare instance because it is off label and because it's so new and so we we are conservative with medications we will occasionally we have occasionally recommended suag glutide or the glp1 um drugs and um in one case in particular it was very striking the extent to which this individual with treatment refractory alcohol use disorder indorsed the complete cessation of alcohol craving um with uh semaglutide and you know it's it's very moving to see that in an individual who has struggled so long long and so hard uh to battle their addiction and then there's this drug that seems to um just suddenly turn off all the noise for them
we will occasionally we have occasionally recommended suag glutide or the glp1 um drugs and um in one case in particular it was very striking the extent to which this individual with treatment refractory alcohol use disorder endorsed the complete cessation of alcohol craving um with uh semaglutide
in one case in particular it was very striking the extent to which this individual with treatment refractory alcohol use disorder endorsed the complete cessation of alcohol craving um with uh semaglutide
yes and so that's how we could justify it right because uh he we were giving it to him for being overweight for um not having type two diabetes but being at risk for type two diabetes um but but the our real agenda was the alcohol and it worked very well for that