Semaglutide is currently used to treat type 2 diabetes and obesity. Pre-clinical evidence suggests that the drug may modulate dopamine-related reward mechanisms, and protect against neuronal degeneration and inflammation. It is, therefore, under consideration for use in neurological, psychiatric, and substance use disorders.
In July 2023, however, regulatory agencies in the EU and UK began to review the drug’s safety following reports of worsening mood and suicidal behavior among users. Although the US FDA issued a preliminary evaluation suggesting no causal link, further studies are needed to determine how the drug affects brain health.
In the current study, researchers examined electronic health records from the USA, including patients with type 2 diabetes who had, between 2017 and 2021, either been prescribed semaglutide or other diabetes drugs: sitagliptin, empagliflozin, and glipizide. They then compared their risk of 22 neurological and psychiatric outcomes within a year of index prescription. Conditions included dementia, migraine, nicotine misuse, depression, suicidality, and more.
Ultimately, the researchers found that liraglutide was not linked to an increased risk of neurological or psychiatric outcomes compared to other drugs. The drug was, in fact, linked to a reduced risk for several outcomes, such as cognitive deficit when compared to sitagliptin and glipizide, dementia compared to sitagliptin, and nicotine misuse across most comparisons.
“Our results suggest that semaglutide use could extend beyond managing diabetes, potentially offering unexpected benefits in the treatment and prevention of cognitive decline and substance misuse,” said lead author of the study, Dr Riccardo De Giorgi, Clinical Lecturer at the University of Oxford in a press release.
“The findings of our study therefore not only help reassure the millions of patients relying on semaglutide for diabetes management, but, if confirmed, might also have significant implications for public health in terms of reducing cognitive deficit and smoking rates among patients with diabetes,” added de Giorgi.
“Our study is observational and these results should therefore be replicated in a randomised controlled trial to confirm and extend our findings,” said senior author fo the study, Dr. Max Taquet, Clinical Lecturer at the University of Oxford, in the press release.
Sources: Neuroscience News, eClinicalMedicine
