Summary: A new study finds that semaglutide, known as Ozempic/Wegovy, does not negatively impact brain health and may reduce cognitive problems and nicotine dependence. The analysis, using over 100 million patient records, revealed no increased risk of neurological or psychiatric conditions compared to other antidiabetic medications.
These findings suggest semaglutide’s benefits may extend beyond diabetes management. Further research is needed to confirm these potential benefits.
Key Facts:
- No Negative Impact: Semaglutide does not increase the risk of neurological or psychiatric conditions.
- Potential Benefits: Associated with lower risk of cognitive problems and nicotine dependence.
- Extensive Data: Analysis used over 100 million patient records, including 20,000 on semaglutide.
Source: University of Oxford
Semaglutide – widely known as Ozempic/Wegovy – does not negatively impact brain health and is associated with lower risk of cognitive problems and less nicotine dependence, according to a new study.
The analysis, conducted by researchers from the University of Oxford and supported by the National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre and the Medical Research Council, revealed that taking the drug, a popular medication for type II diabetes, had no increased risk of adverse neurological or psychiatric outcomes compared to other antidiabetic medications, challenging recent concerns about the drug’s safety.
The comprehensive analysis, published in the journal eClinicalMedicine, used more than 100 million patient records in the USA including over 20,000 who were taking semaglutide. It found that semaglutide:
- Was not associated with an increased risk of neurological and psychiatric conditions, such as dementia, depression, or anxiety, compared to other common anti-diabetic medications
- Was associated with a lower risk of cognitive problems and nicotine dependence.
“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 Dr Riccardo De Giorgi, Clinical Lecturer at the University of Oxford and lead author of the study.
“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.”
While the study’s robust methodology and extensive data provide strong evidence, researchers say further investigation is needed and that it remains unclear how semaglutide may be having these effects.
“Our study is observational and these results should therefore be replicated in a randomised controlled trial to confirm and extend our findings,” said Dr Max Taquet, Clinical Lecturer at the University of Oxford and senior author of the study.
“Nevertheless, they are good news for patients with psychiatric disorders, who are at an increased risk of diabetes.”
Dr De Giorgi adds that while semaglutide is also used in people with obesity, with some diabetes patients also presenting with a higher weight, the findings from this study cannot be applied to people who do not have diabetes.
About this neuropharmacology research news
Author: Riccardo De Giorgi
Source: University of Oxford
Contact: Riccardo De Giorgi – University of Oxford
Image: The image is credited to Neuroscience News
Original Research: Open access.
“12-month neurological and psychiatric outcomes of semaglutide use for type 2 diabetes: a propensity-score matched cohort study” by Riccardo De Giorgi et al. eClinicalMedicine
Abstract
12-month neurological and psychiatric outcomes of semaglutide use for type 2 diabetes: a propensity-score matched cohort study
Background
While semaglutide, approved for type-2 diabetes mellitus (T2DM), is being investigated as a treatment for brain disorders, concerns over adverse neuropsychiatric events have emerged. More data are therefore needed to assess the effects of semaglutide on brain health. This study provides robust estimates of the risk of neurological and psychiatric outcomes following semaglutide use compared to three other antidiabetic medications.
Methods
This retrospective cohort study used electronic health records from TriNetX US Collaborative Network, covering >100 million patients in the USA. Due to the exploratory nature of this study, we did not use a pre-registered protocol or statistical analysis plan.
Three cohorts with T2DM prescribed semaglutide between 1st December 2017 and 31st May 2021 were propensity-score matched (1:1 using a greedy nearest-neighbour algorithm with calliper distance of 0.1) with cohorts receiving sitagliptin, empagliflozin, and glipizide.
Using Cox regression analysis, we compared the risks of 22 neurological and psychiatric outcomes within one year since the index prescription: encephalitis, parkinsonism, cognitive deficit, dementia, epilepsy/seizure, migraine, insomnia, nerve disorder, myoneural junction/muscle disease, intracranial haemorrhage, ischaemic stroke, alcohol misuse, opioid misuse, cannabis misuse, stimulants misuse, nicotine misuse, psychosis, bipolar disorder, depression, anxiety, obsessive-compulsive disorder, and suicidality. Negative control outcomes (NCOs) were used to assess unmeasured confounding.
Findings
Each matched cohort included 23,386 (semaglutide vs sitagliptin), 22,584 (vs empagliflozin), and 19,206 (vs glipizide) patients. Semaglutide was not associated with an increased risk of neurological and psychiatric outcomes.
Instead, after multiple-testing correction, semaglutide was associated with reduced risk for several such outcomes, notably cognitive deficit compared to sitagliptin (HR 0.72, 95% CI 0.64–0.80) and glipizide (HR 0.72, 95% CI 0.63–0.81), dementia compared to sitagliptin (HR 0.52, 95% CI 0.40–0.68), and nicotine misuse across most comparisons (HR 0.72, 95% CI 0.61–0.85 against glipizide; HR 0.77, 95% CI 0.65–0.90 against empagliflozin; HR 0.82, 95% CI 0.70–0.95 against sitagliptin, though the latter was no longer statistically significant after adjustment for multiple comparisons).
Empagliflozin showed fewest differences from semaglutide. No differences in NCOs were observed between cohorts.
Interpretation
Semaglutide is not associated with higher 12-month risk of adverse neuropsychiatric outcomes compared to other antidiabetic medications. Potential beneficial associations with some outcomes, especially cognitive deficit and nicotine misuse, should stimulate validation in clinical trials.
Funding
National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre, Medical Research Council.
