Use of glucagon-like peptide-1 (GLP-1) receptor agonists, specifically semaglutide and liraglutide, is associated with a reduced risk of worsening symptoms of depression and anxiety in people with diabetes and obesity. This finding comes from researchers led by Heidi Taipale at the Karolinska Institutet, who published the results of a cohort study in The Lancet Psychiatry.
People with diabetes have an elevated risk of developing depression and anxiety disorders. To assess the effect of these medications on mental health, the researchers analysed data from national Swedish electronic health registers from 2009 to 2022. The study cohort included 95,490 individuals with a diagnosis of depression or anxiety disorder who used antidiabetic medications. The mean follow-up period was 5.2 years.
In the overall cohort, 22,480 individuals (23·5%) used GLP-1 receptor agonists, of whom 13,445 used semaglutide and 10,534 used liraglutide. Periods of semaglutide and liraglutide use were associated with a lower risk of worsening mental illness compared with periods when the same patients were not receiving these medications. For exenatide and dulaglutide, no such association was observed.
Compared with other antidiabetic medications, semaglutide was associated with a 33% lower risk of worsening mental illness. The results were consistent for men and women. When analysing data only after the approval of semaglutide in Europe in 2018, the drug still showed a lower risk of worsening mental illness (relative risk 0·62).
Overall, semaglutide use was associated with a reduced risk of worsening depression and worsening anxiety. Liraglutide, in turn, was associated only with a lower risk of worsening depression.
The researchers note that these findings indicate the potential efficacy of GLP-1 receptor agonists in patients with depression and anxiety; however, randomised controlled trials with diverse samples are needed to confirm them.
At the same time, other studies point to possible risks. For instance, researchers from the University of Ottawa analysed more than 30 million adverse event reports submitted to the FDA between 2017 and 2024 and found that semaglutide might be associated with an increased risk of ischaemic optic neuropathy—a rare complication known as “eye stroke”.
