Wernicke's Encephalopathy Following Semaglutide Treatment for Obesity: A Systematic PRISMA Review of Case-Based Evidence.
Level 4 - case-series / case-control
Systematic review of case reports
PubMed 42399213 · doi:10.1002/oby.70256
What was done
Authors conducted a systematic review following PRISMA guidelines across PubMed, Embase, CINAHL, and Scopus to identify published case reports of Wernicke's encephalopathy in patients prescribed semaglutide for obesity.
What was found
Six cases were identified. All 6 patients experienced prolonged gastrointestinal symptoms and substantial weight loss prior to neurological deterioration. Common clinical manifestations were altered mental status and oculomotor abnormalities. Several cases resulted in poor outcomes, including progression to Korsakoff syndrome or death; exact numerical counts for specific outcomes were not provided in the abstract.
Why it matters
This review raises clinical awareness that severe gastrointestinal adverse effects and appetite suppression from GLP-1 receptor agonists can lead to thiamine deficiency and life-threatening neurological complications if untreated.
Limits
The review relies entirely on six case reports, precluding any estimate of incidence, relative risk, or definitive causality. Publication bias is likely, and the abstract lacks quantitative details on drug dosing, duration of treatment, and individual patient outcomes.
Cited by
- supports Severe neurological presentations linked to high-dose GLP-1 use are caused by acute thiamine (vitamin B1) deficiency leading to Wernicke's encephalopathy.