Semaglutide is a glucagon-like peptide 1 receptor agonist (GLP1-RA) approved for type 2 diabetes mellitus (Ozempic) and obesity (Wegovy).
1 GLP1-RAs type medications have been recognized as a significant scientific breakthrough. 2 Millions of people worldwide have been using these medications to lose weight as well as to treat diabetes. As a result of the rapidly expanding patient reliance on this medication any report of potential side effects of these medications makes it an even more urgent matter.
In July of 2023, the European Medicines Agency and the UK Medicines and Healthcare products Regulatory Agency responded to reports of possible psychiatric side effects, and began a review of these medications’ safety. 18 The US Food and Drug Administration also reviewed this possibility and they released their statement that there appeared to be no causal link between use of semaglutide and psychiatric side effects. Nevertheless these concerns resulted in an anxious public requiring a more definitive response in terms of further research into the matter… 20
This Comprehensive Study Showed That:
- Semaglutide (Ozempic- Wegovy) was not associated with an increased risk of suicide or any psychiatric or neurological conditions, such as dementia, depression, or anxiety.
- ALSO
- Semaglutide was associated with a lower risk of cognitive problems
- Semaglutide helps nicotine dependence
The analysis, was done by University of Oxford researchers. The National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre and the Medical Research Council, supported this large study which revealed that the use of semaglutide for type II diabetes, did not cause any increased risk of adverse psychiatric or neurologic side effects or health problem compared to the use of other antidiabetic medications.
The was a very comprehensive analysis using E medicine records, published in the journal eClinicalMedicine. They were able to study over 100 million patient records in the United States with over 20,000 being prescribed semaglutide.
Lead author at the University of Oxford Dr Riccardo De Giorgi, says: “Our results suggest that semaglutide use could extend beyond managing diabetes, potentially offering unexpected benefits in the treatment and prevention of cognitive decline and substance misuse. The findings of our study therefore not only help reassure the millions of patients relying on semaglutide for diabetes management, but, if confirmed, might also have significant implications for public health in terms of reducing cognitive deficit and smoking rates among patients with diabetes.”
While this study’s extensive data provides strong evidence, further investigation is needed. It is not known just how semaglutide works in exhibiting these effects. “Our study is observational and these results should therefore be replicated in a randomised controlled trial to confirm and extend our findings,”
Senior author of the study Dr Max Taquet, a Clinical Lecturer at the University of Oxford states that these studies “…are good news for patients with psychiatric disorders, who are at an increased risk of diabetes.” Although part of the popularity and success of semaglutide is its effectiveness in helping patients achieve weight loss, an important goal for many with Type 2 diabetes.This study’s subjects were all people with diabetes. Therefore, the conclusions of this study cannot be confidently applied to people who do not have diabetes. Although there is no reason to believe these findings will not be duplicated in studying non diabetic patients, that work still needs to be done.
Study Methodology- This study used the electronic health records from TriNetX US Collaborative Network, covering >100 million patients in the USA. Twenty thousand people were prescribed semaglutide. The large sample size, and comparisons across a range of other antidiabetic agents, contributes to the strength of this study. Analysis compared the risks of 22 neurological and psychiatric outcomes within one year of being prescribed the medication. They evaluated the presence of the following neurological conditions (and others): Parkinsonism, Cognitive deficit and Dementia, Insomnia, Ischaemic stroke, Alcohol abuse, Misuse disorders of Cannabis, Opioids, Stimulants, Nicotine, they also evaluated if there were any findings related to bipolar disorder, depression, anxiety, suicidality.
Final Study Interpretation:
“Semaglutide is not associated with higher 12-month risk of adverse neuropsychiatric outcomes compared to other antidiabetic medications. Potential beneficial associations with some outcomes, especially cognitive deficit and nicotine misuse, should stimulate validation in clinical trials.”
Healthcare spending on these medications is predicted to grow even more as new indications,3 for these and other similar medications are made available.5 Randomised controlled trials have already confirmed the beneficial effect of semaglutide on metabolic parameters 6 and cardiovascular morbidity and mortality.7 Further studies are being done to evaluate the effects of these medications in patients with other chronic diseases.8 Pre-clinical evidence suggests that these medications have neurobiological activity, including protection against neuronal degeneration and inflammation, as well as having effects on dopamine-related reward systems.9, 10, 11, 12 Because of these findings semaglutide is being considered for clinical use in a variety of neurological, psychiatric, and substance use disorders.13, 14, 15, 16, 17
The effects of semaglutide on brain health still needs further study. In this regard, studies using electronic health records can provide valuable information about the effectiveness22 and safety23 of semaglutide for conditions other than glycaemic control.24 Semaglutide is a glucagon-like peptide 1 receptor agonist (GLP1-RA) licensed for type 2 diabetes mellitus (T2DM) and obesity.1
As these GLP1-RAs have been recognized as a scientific breakthrough 2 their use is predicted to expand further as novel indications,3 formulations,4 and related medications5 become available.
This study provides the first large-scale data on psychiatric and neurological outcomes after 12-months of use of semaglutide in patients with Type 2 Diabetes. There was no evidence of an increased risk of 22 neurological and psychiatric problems- and there is a possible protective association for cognition and nicotine misuse.
The observation was that semaglutide use was associated with lower risks of cognitive deficits / dementia.
Given that the association of semaglutide and lower risk of nicotine use disorder begs for more research to investigate the potential role of semaglutide in the addiction treatment.15 That semaglutide was not associated with an increased risk for any psychiatric outcomes is important. The lack of psychiatric adverse outcomes is highly relevant to the care of patients with Type 2 Diabetes have a high burden of mental illness,29 while this also provides reassurance to the general population.20 The lowering of mortality for semaglutide users is of paramount importance 30. If this can be confirmed, the protective effect of semaglutide on mortality would be extremely important for health advisory panels educating the public and for making national policies. It might in part be mediated by the association of semaglutide with lower cognitive and addictive burden, as well as with the protective effect of semaglutide on other body systems.7, 8
In summary, semaglutide use is not associated with higher risks of onset or recurrence of neurological and psychiatric outcomes in the following 12 months compared to other commonly prescribed antidiabetic agents. In contrast, semaglutide has a potential benefit on cognition and nicotine misuse. Our findings can inform current regulatory investigations and public health, and stimulate clinical trials to test the role of semaglutide for the treatment and prevention of cognitive deficits and substance misuse.
