(Press-News.org) PHILADELPHIA— Taking the weight loss medication semaglutide did not increase the risk of depressive symptoms, suicidal thoughts, or suicidal behavior in persons without known major mental health disorders, according to a new study led by researchers from the Perelman School of Medicine at the University of Pennsylvania published this week in JAMA Internal Medicine. Both the Food and Drug Administration (FDA) and the European Medicines Agency are actively monitoring the psychiatric safety of semaglutide and similar medications after post marketing surveillance reports of depression, suicidal thoughts (ideation), and suicidal behavior in patients taking the drugs for the management of type 2 diabetes or obesity.
Semaglutide has emerged as a significant advancement in the field of weight management. Initially developed as a treatment for type 2 diabetes, the drug gained widespread attention after clinical trials showed it reduced baseline body weight by approximately 10%-15%. Weekly injectable medications like semaglutide have become a popular option for healthcare providers to prescribe for patients. As many as 5 million Americans were prescribed semaglutide in 2023, with nearly four in ten taking it for weight management.
The new study, led by Thomas Wadden, PhD, a professor of Psychology in Psychiatry and the former director of Penn’s Center for Weight and Eating Disorders, analyzed data from over 3,500 participants across four major clinical trials. Researchers examined data from the Semaglutide Treatment Effect in People with obesity (STEP) trials – STEP 1, 2, 3, and 5. These studies were crucial in gaining approval from the FDA to use semaglutide 2.4 mg for obesity.
"The STEP trials provide strong evidence that semaglutide 2.4 mg reduces body weight and improves numerous health complications associated with obesity. Our new analyses provide assurance that the medication, when taken by individuals who are free of significant mental health concerns, does not increase the risk of depression, suicidal thoughts, or suicidal behavior,” Wadden said. He noted, however, that further study is needed of the psychiatric safety of semaglutide 2.4 mg when used by persons with current major depressive disorder, other serious mental illness (such as schizophrenia), or a history of suicide attempt. Individuals with such conditions were not included in the STEP trials.
The study examined changes in depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) and assessed suicidal ideation and behavior using the Columbia Suicide Severity Rating Scale. Across the 68-week STEP 1-3 trials, semaglutide-treated participants, as compared to those who received placebo, did not show an increased risk of developing moderately severe symptoms of depression or of suicidal thoughts or behavior. Similar findings were observed in the 104-week STEP 5 study.
Examining all four STEP trials, researchers found that 1% or fewer of participants reported suicidal ideation or behavior during treatment, with no differences between semaglutide 2.4 mg and placebo. Moreover, only 2.8% of the semaglutide-treated participants, versus 4.1% of those who received placebo, reported levels of depression at some point during treatment that required evaluation by a mental health professional. These rates are consistent with the risk of significant depression in the general population. “It is certainly possible that individuals with overweight or obesity who take semaglutide may experience depressive symptoms or suicidal ideation or behavior, but the data suggest that persons not taking semaglutide – in the placebo group in this study - are equally likely to experience these conditions,” said Gregory Brown, PhD, a study co-author and Director of the Penn Center for the Prevention of Suicide at the Perelman School of Medicine. Wadden and Brown noted that their study’s findings for semaglutide are consistent with results of the FDA’s most recent analysis of post-marketing surveillance data for this class of medications which did not find “evidence that use of these medicines causes suicidal thoughts or actions."
If you or a loved one are experiencing a suicidal crisis or emotional distress call the Suicide and Crisis Lifeline at 988.
The study was funded by Novo Nordisk.
Editor’s Note: Wadden has received grants from Novo Nordisk, as well as consulting fees from Novo Nordisk, advisory board service fees from Weight Watchers, and grant support from Eli Lilly.
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Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. The organization consists of the University of Pennsylvania Health System and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school.
The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $550 million awarded in the 2022 fiscal year. Home to a proud history of “firsts” in medicine, Penn Medicine teams have pioneered discoveries and innovations that have shaped modern medicine, including recent breakthroughs such as CAR T cell therapy for cancer and the mRNA technology used in COVID-19 vaccines.
The University of Pennsylvania Health System’s patient care facilities stretch from the Susquehanna River in Pennsylvania to the New Jersey shore. These include the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Chester County Hospital, Lancaster General Health, Penn Medicine Princeton Health, and Pennsylvania Hospital—the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.
Penn Medicine is an $11.1 billion enterprise powered by more than 49,000 talented faculty and staff.
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About The Study: This cohort study, including mostly patients with type 2 diabetes, does not show an association between use of glucagon-like peptide-1 (GLP-1) receptor agonists and an increased risk of suicide death, self-harm, or incident depression and anxiety-related disorders.
Corresponding Author: To contact the corresponding author, Peter Ueda, MD, PhD, email peter.ueda@ki.se.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamainternmed.2024.4369)
Editor’s ...
About The Study: The results of this post hoc analysis suggest that treatment with semaglutide, 2.4 mg, did not increase the risk of developing symptoms of depression or suicidal ideation/behavior vs placebo and was associated with a small but statistically significant reduction in depressive symptoms (not considered clinically meaningful). People with obesity should be monitored for mental health concerns so they can receive appropriate support and care.
Corresponding Author: To contact the corresponding author, Thomas A. Wadden, PhD, email wadden@pennmedicine.upenn.edu.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamainternmed.2024.4346)
Editor’s ...
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