Semaglutide may have benefits for cognitive health and managing substance use disorders,
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist primarily used to treat T2DM and obesity. It works by mimicking the incretin hormones, which increase insulin secretion, decrease glucagon production, and slow gastric emptying, helping to lower blood sugar levels and promote weight loss. The known benefits of semaglutide include improved glycemic control, weight reduction, and potential cardiovascular benefits. However, it may also cause side effects, mostly gastrointestinal, in some patients. The drug has also been associated with thyroid C-cell tumors in rodents, and there is speculation that it may increase the risk of pancreatitis. When it comes to neurological and psychiatric benefits the drug might provide or side effects it may cause, these are still being explored.
After the U.S. Food and Drug Administration (FDA)’s approval of the drug for weight loss, the number of prescriptions skyrocketed, and healthcare spending on GLP1-RAs expected to increase. While still being explored, recent randomized controlled trials (RCTs) have underscored semaglutide’s efficacy in improving metabolic and cardiovascular outcomes, as well as providing benefits for neurological, psychiatric, and substance use disorders.
Despite these benefits, however, safety reviews by the European Medicines Agency (EMA) and the U.K.’s Medicines and Healthcare products Regulatory Agency (MHRA) have raised concerns about mood changes, prompting further research into the neuropsychiatric safety of semaglutide. Furthermore, given the potential for serious health risks (i.e., pancreatitis), the medical community is interested in knowing more about how the benefits of the drug outweigh these risks – if they do.
A recent study published in EClinicalMedicine took a closer look at this by analyzing yearlong neurological and psychiatric outcomes associated with semaglutide use in patients with type 2 diabetes mellitus (T2DM). Participants were identified from previously collected data. The team used data from those aged 18 and above with a diagnosis of T2DM who filled a first prescription of semaglutide between December 1, 2017, and May 31, 2021. There were 23,386 patients in each cohort for the semaglutide vs. sitagliptin comparison, 22,584 patients for the semaglutide vs. empagliflozin comparison, and 19,206 patients for the semaglutide vs. glipizide comparison.
The team found, overall, that semaglutide didn’t increase the risk of any brain or mental health issues compared to the other diabetes drugs studied. In fact, it was linked to fewer problems with thinking and memory compared to sitagliptin and glipizide and had similar results to empagliflozin. It also showed greater potential in reducing the risk of psychosis compared to sitagliptin and glipizide, and a lower risk of dementia than the others. The drug was also less likely to be associated with nicotine addiction, depression, and certain types of strokes. And, perhaps most importantly, the study also found that people taking semaglutide had a lower overall risk of dying from any cause compared to those taking sitagliptin, empagliflozin, or glipizide.
These findings further support semaglutide’s potential benefits for cognitive health and managing substance use disorders, aligning with previous meta-analyses suggesting GLP1-RAs’ advantages for these positiveoutcomes. Many patients have already credited the drug in helping them curb addiction while using it for other purposes, especially problematic alcohol use.
This study, along with its predecessors, opens the doors for further research to be conducted to leverage the benefits of semaglutide in a wider variety of ways, particularly when it comes to supporting mental health and combating addiction.
Sources:
Weight-Loss Drug Semaglutide May Reduce People’s Desire for Alcohol
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