GLP-1 diabetes drugs could stop anxiety and depression worsening, study finds | Drugs

Diabetes medications may prevent anxiety and depression from getting worse, study suggests.

Type 2 diabetes affects more than 800 million people worldwide, and research shows that people with the condition are approximately twice as likely to suffer from depression as the general population.

GLP-1 receptor agonists such as semaglutide are commonly prescribed for diabetes and obesity. Although studies have found other health benefits beyond weight loss and improved blood sugar levels, the effects of medications on mental health remain unclear.

International researchers examined the Swedish health records of almost 95,000 people who were diagnosed with depression or anxiety and who were also taking various diabetes medications between 2009 and 2022.

The study compared periods when patients took GLP1, or other second-line diabetes medications, with those when they did not. Deterioration in mental health was assessed using data on admissions to psychiatric hospitals, sick leave for mental health reasons, hospitalizations for self-harm and deaths by suicide. Published in the Lancet Psychiatry, the research also examined data on new diagnoses of anxiety and depression.

The authors found that semaglutide, the active ingredient in the diabetes drugs Ozempic and Wegovy for weight loss, as well as liraglutide (Saxenda), was associated with a lower risk of worsening mental illness in people with anxiety and depression.

Semaglutide had a 42% lower risk of worsening mental health, while liraglutide was associated with an 18% lower risk. Other GLP-1 drugs, including exenatide and dulaglutide, have not shown the same benefit.

Semaglutide was associated with a 44% lower risk of worsening depression, a 38% lower risk of worsening anxiety, and a 47% lower risk of worsening substance use disorders.

“For anxiety and depression that coexist with diabetes and obesity, semaglutide and, to a lesser extent, liraglutide could be useful therapeutic options with dual efficacy,” the authors concluded.

Dr Markku Lähteenvuo, research director at the University of Eastern Finland, said: “It is possible that in addition to factors such as reduced alcohol consumption, improved body image linked to weight loss or relief associated with better glycemic control in diabetes, direct neurobiological mechanisms are also involved, for example through changes in the functioning of the brain’s reward system. »

In response to the findings, experts have called for caution, including Professor David Nutt, head of the neuropsychopharmacology unit at Imperial College London and chair of the independent scientific committee Drug Science.

He said: “It is well established that better mental health tends to follow from better physical health and since the 1880s we have known that diabetes is associated with depression, although I think it is unlikely that using GLP-1R agonists alone as treatments for depression or anxiety will work. »

Professor Eduard Vieta, Professor of Psychiatry at the University of Barcelona and Editor-in-Chief of the European College of Neuropsychopharmacology Journal, said: “From a clinical perspective, these results are reassuring about the psychiatric safety of GLP-1 receptor agonists and suggest a potential role not only in preventing worsening but also, potentially, in improving mental health outcomes.

“However, they should not yet be interpreted as evidence of a direct therapeutic effect on depression or anxiety.”

The research came from a separate study that found that women taking semaglutide for diabetes before knowing they were pregnant had an 84% higher relative risk of preterm birth than those not taking GLP-1 medications, while the risk was 70% higher with liraglutide.

The academics examined Danish health records for almost 500,000 women, 529 of whom were taking liraglutide or semaglutide when they became pregnant.

The study found that accidental exposure to GLP-1 during early pregnancy was associated with a higher risk of the baby being born before 37 weeks when the drugs were used to treat diabetes, but not in those who took them for weight loss.

Taking semaglutide was associated with an approximately 11% higher absolute risk of preterm birth. Liraglutide showed a 9% increased risk.