GLP1-RA treatment not harmful to mental health

In the treatment of patients with overweight/obesity and/or diabetes, glucagon-like peptide 1 receptor agonists (GLP1-RAs) do not increase the risk of psychiatric adverse events or worsen depressive symptoms but rather confer improvements in quality of life (QOL) and eating behaviour, according to the results of a meta-analysis.

Researchers searched multiple online databases for double-blind placebo-controlled trials comparing psychiatric, cognition, or QOL outcomes between GLP1-RA and placebo in adults with overweight/obesity and/or diabetes.

Outcomes included the risk of psychiatric adverse events (serious and nonserious) and change in mental health symptom severity, health-related QOL, and cognition. Random-effects meta-analysis was performed, and the Cochrane risk-of-bias tool was used to appraise the quality of studies. Certainty of evidence was also evaluated.

A total of 80 randomized controlled trials involving 107,860 patients (mean age 60.1 years, 40.1 percent female) met the eligibility criteria and were included in the meta-analysis. Pooled data showed that compared with placebo, GLP1-RA treatment neither significantly altered the risk of serious psychiatric adverse events (log risk ratio [RR], −0.02, 95 percent confidence interval [CI], −0.20 to 0.17; p=0.87) and nonserious psychiatric adverse events (log[RR], −0.03, 95 percent CI, −0.21 to 0.16; p=0.76) nor negatively influenced depressive symptoms (g, 0.02, 95 percent CI, −0.51 to 0.55; p=0.94).

On the contrary, GLP1-RA treatment was associated with favourable changes in restrained eating (g, 0.35, 95 percent CI, 0.13–0.57; p=0.002) and emotional eating behaviour (g, 0.32, 95 percent CI, 0.11–0.54; p=0.003) relative to placebo.

GLP1-RAs were also associated with improvements in mental health–related QOL (g, 0.15, 95 percent CI, 0.07–0.22; p<0.001), physical health–related QOL (g, 0.20, 95 percent CI, 0.14–0.26; p<0.001), diabetes-related QOL (g, 0.23, 95 percent CI, 0.15–0.32; p<0.001), and weight-related QOL (g, 0.27, 95 percent CI, 0.18–0.35; p<0.001).

The findings provide evidence regarding the psychiatric safety profile of GLP1-RAs, as well as indicate that GLP1-RA treatment contributes to both physical and emotional well-being, according to the researchers.