Ozempic and Antidepressants Often Go Together

The use of Ozempic and similar type 2 diabetes drugs has been linked to increased dispensation of antidepressants, a study shows.

GLP-1 agonists, short for glucagon-like peptide 1 receptor agonists, are type 2 diabetes medications commonly used for weight loss. They have had a major impact on the management of diabetes and obesity in the last two decades, and their effects are now also felt in the economy.

These "miracle" obesity medications that help to lose up to 20% of the body weight have been previously linked to mental side effects, such as depression and suicide ideation, although the findings are inconclusive. Nor did research find GLP-1 agonists to have protective effects against depression.

However, some psychiatrists prescribe GLP-1 agonists to reduce weight gained while using antidepressants and antipsychotics, according to the New York Times's survey of 13 leading mental health facilities and psychiatric departments.

A new study published in Diabetes, Obesity, and Metabolism suggests that the users of GLP-1 agonists took antidepressants at higher rates than patients on other diabetes drugs like insulin.

The study looked at data from 1,746,391 participants, of whom 358,075 were dispensed an antidepressant between 2012 and 2022. Of 24,783 individuals who were dispensed a GLP-1 receptor agonist, about one-third (8,495) were also dispensed an antidepressant.

The dispensation of GLP-1 RAs increased most noticeably after the year 2020 and was particularly high for individuals aged 50 and older.

When compared to other medications for diabetes management, such as insulin, GLP-1 RAs were most strongly associated with the subsequent dispensing of antidepressants.

However, the dispensing of antidepressants does not necessarily mean that a patient has a depressive disorder because these medications can be used to treat other conditions, such as anxiety.

The association with GLP-1 RAs was consistent across different classes of antidepressants and was particularly strong for duloxetine. Besides depression and anxiety disorders, the drug is also approved for the treatment of diabetic neuropathic pain.

"The association between the dispensing of GLP-1 RAs and antidepressants was greater for men than women and did not extend to other psychotropic medicines, such as antipsychotics," the authors concluded.

Diabetes and mental health

Managing life-long conditions like diabetes can be a great source of stress and anxiety, which can only worsen the disease. Feeling stressed out can affect blood sugar levels, as stress hormones make blood sugar rise or fall unpredictably.

Depression rates in people with type 2 diabetes are nearly twice higher than in those without the condition, with women being more affected than men. However, only 25% to 50% of people with diabetes who have depression get diagnosed and treated.

People with diabetes and depression are more likely to experience diabetes burnout, which is a somewhat submission to the condition. It can result in an individual's complete disregard for their blood sugar levels, neglect of a diet, and participation in self-destructive behaviors.

Moreover, people with diabetes are 20% more likely than those without the condition to have anxiety at some point in their life.

It is too early to tell if the use of GLP-1 RAs can increase the risk of depression that requires pharmacological treatment. The study authors don’t rule out the possibility that diabetes patients taking novel drugs are under better medical supervision, allowing them to spot depression symptoms earlier.

If you experience symptoms of depression, such as continuous low mood or feelings of hopelessness, discuss them with your healthcare provider.

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