How Do GLP-1 Drugs Affect The Brain & Mental Health?
- Popular weight-loss drugs like Ozempic (generic name: semaglutide), which are intended for people with type 2 diabetes and also known as GLP-1 agonist drugs, may be beneficial for brain health, but not so much for people struggling with anxiety and depression, according to a new research review.
- A recent review of pre-clinical, mechanistic, and clinical studies, was conducted by researchers to assess how GLP-1 medications (drugs like Ozempic, Wegovy, and Mounjaro) affect cognitive functioning and mental health issues.
- Semaglutide is a GLP-1 receptor agonist, meaning that it mimics the effects of GLP-1 in the body. Given as weekly subcutaneous injections, it is normally prescribed to manage blood glucose levels in diabetic patients. It also leads to a significant amount of weight loss in these patients.
- If you’re considering taking a weight loss drug, talk with your care team about whether that’s a good option for you. And make sure you consider good diet and exercise practices as a part of your treatment plan.
- There are many ways to address mental health issues. Options may include meditation, practicing mindfulness, talking with a therapist, joining a support group, and medication, such as antidepressants.
A newly published analysis on GLP-1 drugs like Ozempic, which 49-year-old comedian Chelsea Handler was previously prescribed, is suggesting that the usage of these type medications for anti-obesity and type 2 diabetes may benefit brain health but worsen symptoms of anxiety and depression.
The research review, published in Nature Mental Health, offers an analysis into how GLP-1 medications (drugs like Ozempic, Wegovy, and Mounjaro) affect cognitive functioning and mental health issues. Read MoreThe researchers also explain, “In the United States, prescribing information for all medications licensed for obesity that act on the CNS [Central Nervous System], including the GLP-1RAs liraglutide 3 mg (Saxenda) and semaglutide 2.4 mg (Wegovy), must include the recommendation of monitoring for depression and suicidal ideation.
“This, however, does not apply to other GLP-1RAs approved for the treatment of T2DM [type 2 diabetes mellitus], including the same liraglutide (Victoza) and semaglutide (Ozempic or Rybelsus) at lower dosages, prompting several stakeholders to request.”
They suggest patients taking GLP-1s to be monitored and additional research is needed on how GLP-1 drugs can protect mental health, as there are limited studies on the matter.
The researcher continued, “Indeed, the history of anti-obesity medications has been marked by several failures due to serious adverse events, such as suicidality, observed only after their usage had become extensive—a well-known example being the one that led to the withdrawal of the endocannabinoid inverse agonist, rimonabant.
“Many have advocated that the associations between low mood, suicidal behavior and anti-obesity drugs such as GLP-1RAs are confounded by the pre-existing higher prevalence of neuropsychiatric disorders observed in people living with obesity compared with the general population. More recently, the European Medicines Agency Pharmacovigilance Risk Assessment Committee concluded that the available evidence does not at present support a causal association between GLP-1RAs and suicidality. Overall, as GLP-1RAs become increasingly prescribed, further pharmacovigilance studies are warranted.”
Chelsea Handler’s Mental Health Struggles & Ozempic Experience
On the topic of mental health and Ozempic, comedian and actress Chelsea Handler, 49, comes to mind as she’s been open about her struggle with anxiety and she addressed her previous GLP-1 usage in an earlier interview.
Two years ago, Handler admitted on the “Call Her Daddy” podcast, as per People, that she unknowingly was taking Ozempic, explaining, “So, my anti-aging doctor just hands it out to anybody.
“I didn’t even know I was on it. She said, ‘If you ever want to drop five lbs., this is good.'”
Handler continued, “I came back from a vacation and I injected myself with it. I went to lunch with a girlfriend a few days later, and she was like, ‘I’m not really eating anything. I’m so nauseous, I’m on Ozempic.’
“And I was like, ‘I’m kind of nauseous too.’ But I had just come back from Spain and was jet-lagged.”
It was then her friend questioned what drug Handler was taking, and when she said “semaglutide,” thats when she realized.
Handler eventually learned it wasn’t needed for her to take the drug, adding, “I’m not on it anymore. That’s too irresponsible. I’m an irresponsible drug user, but I’m not gonna take a diabetic drug. I tried it, and I’m not gonna do that. That’s not for me. That’s not right for me.
“I’ve injected about four or five of my friends with Ozempic because I realized I didn’t wanna use it cause it’s silly. It’s for heavy people. Everyone is on Ozempic. It’s gonna backfire, something bad is gonna happen.”
In another interview, with ETalk TV, Handler is seen praising the drug as a “miracle for anyone wanting to lose weight.”
@etalkctv Chelsea Handler opens up about her Ozempic usage and its spread across Hollywood. Watch our full interview with Chelsea Handler on our YT. #ChelseaHandler #interview #Ozempic #weightloss #hollywood
As for the anxiety she’s dealt with, she wrote about it in a June 2017 issue of InStyle, where she explained, “My anxiety manifests itself in different ways. Sometimes it’s just in my head and feels overwhelming, as if I’ve agreed to do too much. Other times, when I’m really nervous, my leg shakes.
“Anxiety doesn’t have to be such a dirty word. It can be there for us to harness and turn into something fierce… I know I can flip that worry into something powerful.”
In another interview, Handler commended going to intensive therapy as the “best gift” she’s ever given herself.
She explained, “I went to therapy for about two years, really intensive therapy, when I turned 40. It was the best gift I ever gave myself because it gives you the gift of self awareness.
“You realize not everybody needs that interaction and it’s not your job to be that person all the time. And I can’t even express enough, and there are not enough words in the human language to express how much happier I am as a person.”
Understanding GLP-1 Receptor Agonists
GLP-1 receptor agonists (GLP-1RAs) are a group of medications primarily used to manage type 2 diabetes. They help lower blood sugar levels by mimicking a natural hormone in the body that regulates insulin release and appetite. In recent years, these drugs—like semaglutide (Ozempic, Wegovy) and liraglutide (Victoza, Saxenda)—have also gained popularity for their effectiveness in promoting weight loss.
In the past year or so, story after story has been published about the surprising effects these drugs can have. In addition to weight loss, there have been reports that the drugs can reduce people’s urge to drink, help them quit smoking, and even resolve certain fertility issues. It’s been touted in the media as a sort of miracle drug, however, much more research is needed.
Scientists have long known that obesity is linked to higher cancer risk, but whether GLP-1RAs could reduce this risk had not been extensively studied—until now.
These drugs, like semaglutide, work by impacting the glucagon-like peptide-1 (GLP) GLP-1 hormone.
Semaglutide is a GLP-1 receptor agonist, meaning that it mimics the effects of GLP-1 in the body. Given as weekly subcutaneous injections, it is normally prescribed to manage blood glucose levels in diabetic patients. It also leads to a significant amount of weight loss in these patients.
Integral to blood sugar control, GLP-1 is a hormone released by the gut in response to food. It causes the pancreas to release insulin. A rising blood insulin level causes all the body tissues to start absorbing glucose (blood sugar) from the bloodstream, thereby lowering blood glucose levels. GLP-1 also prevents the release of glucagon, which is a hormone that raises blood sugar levels by stimulating liver cells to release glucose and helps people feel full for longer. These effects can also cause people to lose weight.
Although semaglutide has been approved for blood sugar control in people with type II diabetes under the brand name Ozempic, and for weight loss under the brand name Wegovy, it has not been approved for use as an immune booster or cancer preventive. Thus, it should not be prescribed for that purpose. Those taking it to control their diabetes or weight, however, can expect the additional benefit of improving their immunity, as per a recent study, and lowering their cancer risk, as a link between weight and cancer does exist.
It’s important to note that there are a variety of drugs available right now for weight loss, such as Novo Nordisk’s semaglutide — which can be purchased under the brand names Ozempic, Wegovy, and Rybelsus — and Tirzepatide, sold under the brand names Mounjaro and Zepbound. Others include Phentermine (Adipex-P, Lomaira), a prescription medication that reduces appetite; Contrave (naltrexone/bupropion); and bupropion (the generic form of Wellbutrin).
Health Risks Associated With Ozempic
Although people have had success with weight loss thanks to Ozempic, it’s important to understand there are dangers associated with “chasing skinny.” Healthcare company Lexicomp recently shared negative side effects of the medication, including an increased risk of cancer.
Lexicomp explains Ozempic as “an injectable prescription medicine for adults with type 2 diabetes mellitus that: along with diet and exercise may improve blood sugar (glucose),” noting it’s not the first choice of medicine for treating diabetes.
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As for the most important information people should know before taking the drug, Lexicomp says Ozempic may cause serious side effects. Some of the possible side effects include:
- inflammation of your pancreas (pancreatitis)
- changes in vision
- low blood sugar, kidney problems
- kidney failure
- serious allergic reactions.
“The most common side effects of OZEMPIC may include nausea, vomiting, diarrhea, stomach (abdominal) pain and constipation. Talk to your healthcare provider about any side effect that bothers you or does not go away,” Lexicomp states.
“These are not all the possible side effects of OZEMPIC. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.”
The Memorial Sloan Kettering Cancer Center also says, regarding Lexicomp’s warning, “This drug has been shown to cause thyroid cancer in some animals. It is not known if this happens in humans.
“If thyroid cancer happens, it may be deadly if not found and treated early. Call your doctor right away if you have a neck mass, trouble breathing, trouble swallowing, or have hoarseness that will not go away.
“Do not use this drug if you have a health problem called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or if you or a family member have had thyroid cancer.”
The side effects that call for immediate medical attention, in regard to all uses of the drug, the MSKCC lists as:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
- Signs of gallbladder problems like pain in the upper right belly area, right shoulder area, or between the shoulder blades; change in stools; dark urine or yellow skin or eyes; or fever with chills.
- Severe dizziness or passing out.
- A fast heartbeat.
- Change in eyesight.
- Low blood sugar can happen. The chance may be raised when this drug is used with other drugs for diabetes. Signs may be dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or sweating. Call your doctor right away if you have any of these signs. Follow what you have been told to do for low blood sugar. This may include taking glucose tablets, liquid glucose, or some fruit juices.
- Severe and sometimes deadly pancreas problems (pancreatitis) have happened with this drug. Call your doctor right away if you have severe stomach pain, severe back pain, or severe upset stomach or throwing up.
For anyone using GLP-1 drugs for weight loss, or for its intended prescribed purpose, be sure to report any side effects immediately to your medical team, and of course, be sure to consult with them before you take the medication to determine whether or not it is right for you and your personal health history.
Taking Care of Your Mental Health
Taking care of your mental health isn’t always easy, but it should always be a priority. One place to start is simply being aware of how you’re feeling and reflecting on any changes you’ve noticed in your emotions or behaviors.
According to the National Institute of Mental Health, you should see a professional if you are experiencing severe or distressing symptoms that have lasted two weeks or more, such as:
- Trouble sleeping
- Changes in appetite
- Struggling to leave bed in the morning because of your mood
- Trouble concentrating
- Loss of interest in things you normally enjoy
- Inability to perform normal daily functions and responsibilities
It’s important to try to get help before your symptoms of a mental health issue become overwhelming. Talk with your primary care doctor about any concerns you’re having, so they can refer you to a mental health professional if needed.
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Therapy can also be a way of taking care of your mental health. But know you might need to shop around for the right therapist. Ovarian cancer survivor Ni Guttenfelder says finding the right counselor allowed her to work through the complex emotions of her cancer battle.
“One of the things that my counselor has taught me from the very beginning that has helped me is the concept of acceptance,” she said. “Acceptance is a process. It’s like downloading a computer file in increments. Visualizing it in that way has really helped me.”
Meditation and practicing mindfulness can also be great tools in mental health care. Dr. Deepak Chopra, acclaimed author and pioneer of mindfulness movement, previously spoke with SurvivorNet about mindfulness. He says asking yourself who you are is the first step on the path to practicing mindfulness.
“If we can combine our actions in the world with reflective self inquiry, love and compassion, and a state of secure, stable, ornamental, peaceful being without the addictions that humans have, then we can begin our journey of healing,” Dr. Chopra explained.
In addition, medications can also help people with a mental health illness. They are not necessary for everyone, but medications can make a difference. And there should be no shame attached to taking them.
That being said, it can be tricky to find the right one and your needs may change over time. Psychiatrist Dr. Lori Plutchik says genetic testing through Genomind can help. It gives a profile of how a person is likely to respond to different types of psychiatric medications.
MORE: How Can Genetic Testing Help Determine the Right Form of Mental Health Treatment?
“Doing the genetic testing has absolutely transformed the landscape of psycho-pharmacology,” Dr. Plutchik told SurvivorNet. “It’s something that I highly recommend for anybody that is taking medication, whether they are being treated for cancer, or not.
“I recommend it for children who are taking medication. I recommend it for elderly people. Anybody who is taking medication, I think, can greatly benefit from genetic testing.”
Questions to Ask Your Doctor
- What type of treatment should I seek if I’m struggling with negative thoughts?
- Are there any local support groups for people in my situation?
- How might struggling with mental health affect my treatment?
- Should I consider medical interventions such as antidepressants?
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
