Semaglutide, Cognitive Function and Psychiatric Outcomes
Semaglutide, Cognitive Function and Psychiatric Outcomes
— By Dawn M. Sweet, Ph.D.
Researchers are exploring the relationship between semaglutide and cognitive function and psychiatric outcomes.
GLP-1 medications cross the blood brain barrier, and researchers are now investigating what the effects are. (For example, Ozempic’s effects on brain chemistry are to date well documented — e.g., signaling the reward system, dopamine modulation, gut-brain interaction.1,2) Researchers are now exploring the relationship between semaglutide and cognitive function and psychiatric outcomes.2
Previous research has established that GLP-1 RA medications have neurobiological activity inclusive of neuronal degeneration and inflammation, as well as modulation of dopamine-related mechanisms.2 New research is exploring the association between semaglutide and cognitive function and psychiatric outcomes.
A retrospective cohort study of electronic health records included adults 18 and older with type 2 diabetes who were within one month of their first semaglutide prescription. Records were pulled from TriNetX US Collaborative Network. There were three matched cohorts: semaglutide vs. sitagliptin (n = 23,386), semaglutide vs. empagliflozin (n = 22,584), and semaglutide vs. glipizide (n = 19,206).
Risk was assessed for the diagnosis of 22 neurological and psychiatric outcomes (e.g., Parkinson’s, cognitive deficit, dementia, seizures and depression) in a time-to-even analysis. Results suggest that semaglutide was not associated with an increased risk of a first diagnosis of a neurological or psychiatric condition. The authors note that the risk of cognitive deficits was significantly lower after semaglutide compared to sitagliptin (HR 0.72, 95% CI 0.64–0.80, padj < 0.0001) and glipizide (HR 0.72, 95% CI 0.63–0.81, padj < 0.0001), but similar between semaglutide and empagliflozin (HR 0.96, 95% CI 0.86–1.08, padj 0.51). Likewise, the risk of dementia was lower after semaglutide compared to sitagliptin (HR 0.52, 95% CI 0.40–0.68, padj < 0.0001) and glipizide (HR 0.63, 95% CI 0.46–0.86, although this did not reach significance after correction, padj 0.075). The risk was similar between semaglutide and empagliflozin (HR 0.91, 95% CI 0.69–1.21, padj 0.53).
These findings are important because many patients with type 2 diabetes experience depression, anxiety, or stress related to living with a chronic illness that requires continuous monitoring. Recently concerns about suicidality and semaglutide have been noted. This study did not find an association between semaglutide use and depression and could be used to inform future research in this area.
Implications for Clinical Practice
When starting a new medication, patients frequently worry about their side effects. Although semaglutide has side effects, the research discussed above found no evidence for cognitive or psychiatric side effects. When starting patients with type 2 diabetes on semaglutide, health care providers could assuage patient concerns with the empirical evidence offered above. Further, providing scientifically formulated meal replacements to these patients can ensure that their nutritional needs are met while helping to alleviate GLP-1 side effects.
Source(s):
2 Hormonal gut-brain signaling for the treatment of obesity
About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.
About Robard: Robard Corporation’s medical obesity treatment programs and scientifically-designed nutrition products are utilized by physicians, surgeons and hospitals across the United States to successfully treat patients living with obesity. To learn more about us and how we can help your practice and patients, visit us online at www.Robard.com, email us at info@robard.com, or call (800) 222-9201.
