The risk of depression, anxiety, and suicidal behavior in patients with obesity on glucagon like peptide-1 receptor agonist therapy

Scientific Reports volume  14, Article number: 24433 (2024 ) Cite this article

This large community-based cohort study investigates the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), specifically Liraglutide and Semaglutide, on the risk of developing psychiatric conditions such as depression, anxiety, and suicidal behaviors in patients with obesity. Utilizing post-marketing data, this research compares patients prescribed GLP-1 RAs (cases) with those not taking these medications (controls). The analysis spanned data from January 1, 2015, to December 31, 2023. To minimize selection bias, we employed 1:1 propensity score matching to account for demographic factors such as age, sex, race, and comorbidities. After matching, the study included 162,253 case and control patients. This study showed a significant association between GLP-1 RA treatment and an 98% increased risk of any psychiatric disorders. Notably, patients on GLP-1 RAs exhibited a 195% higher risk of major depression, a 108% increased risk for anxiety, and a 106% elevated risk for suicidal behavior. These findings underscore the critical need for physicians to thoroughly assess patient history before prescribing GLP-1 RAs and highlight the urgent requirement for further prospective clinical trials to fully understand the implications of GLP-1 RA use on mental health in the obese patient population.

The increasing global incidence of obesity is a major public health concern, escalating at a concerning rate and posing significant challenges to healthcare systems worldwide1. Obesity is a complex, multifactorial disorder, characterized not only by excessive fat accumulation but also by its association with a wide range of complications. These complications are extensive and diverse, encompassing metabolic disorders such as type 2 diabetes2, dyslipidemia3, cardiovascular diseases4 and an increased overall mortality risk5. Additionally, obesity contributes to joint and musculoskeletal disorders6, mental health challenges7, and a heightened risk of various cancers8. This broad spectrum of complications emphasizes the critical need for effective management strategies.

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