The risk of depression, anxiety, and suicidal behavior in patients with obesity on glucagon like peptide-1 receptor agonist therapy.
Level 3 - non-randomized controlled study
Retrospective propensity score-matched cohort study using observational post-marketing data.
PubMed 39424950 · doi:10.1038/s41598-024-75965-2
What was done
This retrospective community-based cohort study analyzed post-marketing observational data collected between January 1, 2015, and December 31, 2023. Patients with obesity prescribed GLP-1 receptor agonists (liraglutide and semaglutide) were compared to unexposed controls. Investigators used 1:1 propensity score matching for age, sex, race, and comorbidities, resulting in a matched cohort of 162,253 case and control patients.
What was found
GLP-1 receptor agonist therapy was associated with a 98% increased risk of any psychiatric disorder. Patients taking GLP-1 RAs had a 195% increased risk of major depression, a 108% increased risk of anxiety, and a 106% increased risk of suicidal behavior. The abstract does not report baseline rates, absolute risk differences, confidence intervals, or specific risk metrics (e.g., hazard ratios or odds ratios).
Why it matters
With the rapid expansion of GLP-1 receptor agonist prescriptions for weight management, identifying potential psychiatric risks is critical for baseline screening and monitoring, highlighting the need for prospective confirmation.
Limits
The study is observational and vulnerable to residual confounding, protopathic bias, and confounding by indication. The abstract does not provide exact effect estimates, confidence intervals, absolute event counts, or follow-up durations. Database-derived psychiatric diagnoses may also be subject to misclassification and ascertainment bias.
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