GLP-1 Medications May Offer Benefits Beyond Weight Loss in Mental Health Care

GLP-1 receptor agonists, such as semaglutide (Ozempic®, Wegovy®) and liraglutide (Victoza®, Saxenda®), are medications originally developed to treat type 2 diabetes and obesity. They work by mimicking a natural hormone that helps regulate blood sugar, appetite, and feelings of fullness. Recently, these medications have received national attention, and psychiatrists are increasingly interested in how they might support mental health treatment. 

Are GLP-1 Medications Safe for People with Mental Health Conditions? 

Early concerns were raised about whether these medications might cause psychiatric side effects. Encouragingly, large research reviews suggest they do not. 

• No Increased Psychiatric Risk: A review of studies involving more than 107,000 patients found no increase in adverse psychiatric side effects in GLP-1 medications compared to placebo. Patients also reported better quality of life. 
• Broad Safety Findings: Another analysis of clinical trials found no increased risk of depression, suicide, anxiety, sleep problems, bipolar disorder, addictive disorders, or schizophrenia among people taking GLP-1 medications. 

Why Psychiatrists Are Using GLP-1 Medications 

• Managing Medication-Related Weight Gain: Many psychiatric medications can cause weight gain, sometimes significantly. Some of the most effective antipsychotic medications can also raise cholesterol and blood sugar. GLP-1 medications may help manage these side effects so patients can stay on the medications that work for them.
• In people taking clozapine or olanzapine, liraglutide led to about 12 pounds of additional weight loss compared to placebo and helped return blood sugar to healthy levels in nearly two-thirds of patients. 
• Semaglutide produced about 20 pounds of additional weight loss compared to placebo in a similar group, along with improved blood sugar. 
• In another study of patients taking clozapine, semaglutide led to nearly 14% body weight loss, compared to less than 1% with placebo, without worsening psychiatric symptoms. 
• Alcohol and Substance Use: Several studies suggest GLP-1 medications may help reduce problematic drinking and other substance use. 
• A study of more than 600,000 U.S. veterans with type 2 diabetes found that starting a GLP-1 medication was linked to lower rates of alcohol, cannabis, cocaine, nicotine, and opioid use disorders, as well as fewer overdoses and emergency visits. 
• A national study found that semaglutide and liraglutide were associated with fewer alcohol-related hospitalizations, performing better than standard alcohol use disorder medications. 
• In a small clinical trial, low-dose semaglutide reduced how much people drank, how many drinks they had on drinking days, and their alcohol cravings. Higher doses appeared to have larger effects. 

Binge Eating: A growing number of small studies suggest GLP-1 medications may reduce binge eating episodes, food cravings, and emotional overeating. Some patients also report less time spent thinking about food. There are no studies yet in bulimia specifically, though there is interest in whether these medications could help with the binge component. However, caution is essential, as there is concern that these medications could encourage or reinforce restrictive eating patterns. 

Emerging Research in Depression and Bipolar Disorder 

Researchers are also exploring whether GLP-1 medications might directly help with other psychiatric conditions. 

• Promising animal research, with early but limited human data, for depression. – Growing interest as a potential treatment in bipolar disorder, including for people who also struggle with substance use. 
• Genetic studies suggest possible protective effects for anxiety, schizophrenia, bipolar disorder, bulimia, and PTSD. 

What to Keep in Mind 

GLP-1 medications are generally well tolerated, but they do require close medical monitoring. The most common side effects involve the digestive system, such as nausea and constipation. Less common but serious risks include pancreatitis, gallbladder problems, kidney issues, and worsening of diabetic eye disease. This is why it’s important to work with a provider who can monitor your overall health throughout treatment. 

Wondering whether a GLP-1 medication could be part of your mental health care? Talk with your psychiatrist or contact our team at 415-945-9870 to learn more about your options.