Q&A: Ozempic & alcohol cravings; Ambien risks; understanding peri-menopause; & heart rate variability as a marker of health

Is it me, or is Christmas earlier this year?🎄

ICYMI 👉

• Your Holiday Survival Guide 🎁

• Let’s Cut Through the Noise about Ozempic & Obesity

• My Favorite Things at the Pharmacy - Arthritis Edition

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In this week’s reader-submitted Q&A, we’re tackling these questions:

• Will Ozempic help my alcohol cravings?

• Is it okay to take Ambien?

• What is perimenopause?

• Is heart rate variability an indicator of aging?

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Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.

Photo by Helena Yankovska on Unsplash

The following subscriber questions have been lightly edited for length and clarity.

QUESTION #1: OZEMPIC AND ALCOHOL USE

I am hearing that people lose their taste for alcohol on Ozempic (and similar medications for weight loss). I would be interested in it for that reason but I don’t know if the side effects are worth it- plus the cost.

- HH

Dear HH,

Yes, we are observing this effect. People who take Ozempic and other GLP1 medications often report reduced cravings for alcohol. They also may find themselves less inclined to pick their skin or engage in other compulsive behaviors. Why is that? These drugs not only tell the pancreas to produce more insulin, they act on the brain’s dopamine pleasure center, such that people who typically over-indulge in food get less of a dopamine “rush” in response to eating. They are less interested in food because the reward circuitry in the brain has changed. It makes intuitive sense, then, the impulse to drink alcohol is dampened when less dopamine is released in response to it.

Just this week, the Financial Times published a great article about the potential uses for Ozempic—linked here.

Could Ozempic be another solution for various addictions? It’s too early to tell. The early observational data on Ozempic’s ability to reduce impulsivity and cravings around various habits is promising. Just this week, Eli Lilly announced it will study the use of GLP1s to treat alcohol, nicotine and drug abuse.

Do I think it will work? In my opinion, medication alone is unlikely to be a magic bullet, given that addiction is a complex bio-psycho-social phenomenon. In other words, targeting the dopamine neurotransmitter receptor in the brain provides only part of a typically more complex solution. That said, if a drug can help the millions of people who suffer from substance use disorders—without doing more harm than good—I welcome it.

I am closely following the Ozempic data and will keep you posted! What are your thoughts about this drug and the fanfare around it?

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QUESTION #2: AMBIEN RISKS

I borrow my husband’s Ambien every now and then and feel guilty about it.. but it really works... and now I want to ask my own doctor… but is it a “no no?” I sleep badly a few nights a week but I feel like it’s a bad sign to ask for a prescription. How bad is Ambien for you?

- Teri

Dear Teri,