Ozempic, Semagulitdes, and Mental Health Disclaimer

This blog post is about how semaglutides impact mental health. Before we dive into the impact, we want to be clear that the decision to take these medications is a personal choice. We work with many patients who are on these medications and many who do not want to use them. The purpose of this article is not to sway you one way or the other, but rather to provide an understanding of some potential mental health implications associated with these drugs.

For the purpose of this article, we are focusing on potential negitive mental health impacts. We are aware there can be positive mental health and physical impacts of these medications and they can be very beneficial for some people.

Please always consult your medical doctor when deciding to take a medication.

 

Introduction: How Semagulitdes Impact Mental Health

With the rise in prescriptions for semaglutide medications like Ozempic and Wegovy, the potential impacts aren’t as widely discussed as the weight loss success stories on social media. As a clinician specializing in eating disorders, depression, and anxiety, the increase in depression and anxiety symptoms seen by both colleagues and clients alike prompted me to dig deeper and seek out more information on the subject.

While semaglutide medications like Ozempic and Wegovy have gained popularity for weight loss, there are ongoing investigations into potential mental health risks, particularly with higher doses used for this off-label purpose. Moreover, due to their ability to slow gastric emptying, these drugs may compromise the effectiveness of oral medications. As the surge of interest in Ozempic and similar semaglutide drugs keeps rising, it’s essential to recognize the need for more research to understand how they might impact mental health and well-being. This blog post aims to shed light on some critical but often overlooked aspects to consider. The exploration calls for a holistic approach to evaluating weight loss medications.

 

What is it?

Ozempic and Wegovy are part of a class of medications called GLP-1 receptor agonists. While they have different names and approved uses, they contain the active ingredient, semaglutide, which mimics a hormone called GLP-1. By activating GLP-1 receptors, these drugs help control appetite, food intake, and blood sugar levels, making them useful for diabetes. However, these medications have grown in popularity for their off-label use for weight loss. Wegovy, the higher-dose semaglutide formulation approved for weight loss, carries a warning on its label about potential adverse mental health effects, including anxiety, depression, and suicidal ideation or attempt. Ozempic, the lower-dose semaglutide formulation approved for diabetes, does not list these mental health side effects on its label despite containing the same active ingredient.

 

Weight Loss Medications Potential Effects on Mental Health

In 2023, concerns over how semaglutides impact mental health prompted investigations. The European Medicines Agency began investigating 150 reports of self-harm and suicidal thoughts linked to these medications. In comparison, the FDA received 489 reports of patients experiencing anxiety, depression, or suicidal ideation while taking semaglutide drugs, including 96 cases of suicidal thoughts.

Research on GLP-1 receptor agonists like Ozempic and Wegovy concludes there is a risk for increased psychiatric symptoms; however, the available evidence remains conflicting. While current research, including case studies and clinical trials, describes potential for experiencing severe adverse psychiatric symptoms such as anxiety, depression, suicidal ideation, and personality changes after initiating GLP-1 receptor agonist treatment, some research suggests that the use of these drugs did not increase psychiatric problems.

 

How it Impacts Psychiatric Symptoms

Semaglutide, a GLP-1 receptor agonist, enhances insulin secretion and sensitivity. Research suggests that semaglutide, on insulin signaling, might disrupt the regulation of the HPA axis, neurotrophic factors, and neurotransmitters involved in depression and other mental health conditions. Increasing evidence links the gut microbiota to mental health through the gut-brain axis communication pathway. Therefore, semaglutide’s effects on insulin could indirectly impact mental well-being by altering the gut microbiome. Additionally, semaglutide’s gastrointestinal side effects, such as vomiting and dehydration, can involve changes to the gut microbiome and can potentially affect mental health. Semaglutide’s mechanism of action in suppressing appetite and interacting with brain regions involved in hunger and satiety may also impact mood and mental health.

While direct research on the connection between semaglutide and mental health via insulin pathways is limited, studies on indirect connections provide insight into possible biological mechanisms and influence pathways implicated in mental health disorders like depression, anxiety, and cognitive impairment.

 

Changes in Absorption of Oral Medications

Ozempic can significantly interact with certain oral medications. This interaction occurs because Ozempic markedly slows gastric emptying, which can substantially impair the absorption of these drugs into the bloodstream. For instance, the seizure drug called Phenytoin (Dilantin) is highly susceptible to such changes, with slight fluctuations in absorption potentially rendering it ineffective. Even minor absorption variations can profoundly impact some critical medications’ efficacy.

While some oral medications may be less affected by these absorption alterations, there is limited data available on how Ozempic or other semaglutide medications impact the effectiveness of prescribed drugs, particularly psychiatric, sleep, and pain medication. Moreover, the extent to which these medications are affected and rendered ineffective is unknown, necessitating individualized care.

Additional considerations have recently emerged over the off-label prescribing of medications for weight loss on whether the risk outweighs the benefits. The FDA has received reports of adverse effects linked to compounded semaglutide products. Alarmingly, some compounders may use different salt forms of semaglutide, such as semaglutide sodium or semaglutide acetate, instead of the approved base form. These salt forms have distinct active ingredients, potentially failing to meet regulatory requirements and posing health hazards to unsuspecting consumers.

 

Conclusion

We recognize that the decision to pursue medical interventions for weight management is complex and multifaceted, influenced by various factors unique to each individual’s circumstances. By exploring the potential mental health considerations surrounding these medications, we aim to empower you to navigate this journey with transparency and a deep respect for your autonomy. Ultimately, our role is to support you in making a well-informed decision that prioritizes your well-being, ensuring that any choice you make is grounded in your unique values.

More research is needed to understand the impacts of these medications on mental health. If you have started weight loss medication and are taking medications for your mental health, it is important to note any changes in symptoms and talk to your provider.

 

Services At Best Within You Therapy & Wellness

At our practice we have a team of therapists and registered dietitians who work with many clients with eating, weight, and body image concerns. We know that asking for help might feel challenging. Our compassionate therapists offer complimentary consultations. We are happy to answer any questions that you have.

Thank you to Dr. Amanda Parker for this article about how semaglutides impact mental health. If you would like to schedule an appointment with Dr. Parker or another therapist or registered dietitian please visit our appointment page.