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The Impact of GLP-1 Receptor Agonists (GLP-1 RAs) on Mental Health: A Systematic Review

  • Silvia Tempia Valenta,
  • Alba Nicastri,
  • Federica Perazza,
  • Federica Marcolini,
  • Valentina Beghelli,
  • Anna Rita Atti,
  • Maria Letizia Petroni

摘要

Purpose

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for managing metabolic disorders such as type 2 diabetes mellitus (T2DM) and obesity. Beyond their metabolic benefits, GLP-1 RAs exhibit neuroprotective and psychotropic effects, potentially benefiting mental health conditions like depression and anxiety. This systematic review aims to synthesize existing evidence on the effects of GLP-1 RAs on mental health outcomes, including both potential therapeutic benefits across various psychiatric disorders and the risk of associated adverse mental health effects.

Methods

This systematic review was conducted across PubMed/MEDLINE and Web of Science. Inclusion criteria encompassed human and animal studies examining the impact of GLP-1 RAs on mental health. Data from 81 selected studies were extracted and analyzed, focusing on mental health outcomes and reported adverse effects.

Findings

GLP-1 RAs exhibit potential beneficial effects on depressive symptoms, cognitive function, and reduced risk of suicidal ideation in animal and human models through antioxidative, anti-inflammatory mechanisms, and modulation of neurotransmitter pathways. Additionally, GLP-1 RAs were effective in reducing alcohol and substance use and binge eating behaviors. Adverse psychiatric effects associated with GLP-1 RAs, including depression, anxiety, and suicidal ideation, are noted in pharmacovigilance analyses, with variations among different GLP-1 RAs.

Summary

GLP-1 RAs hold promise for addressing psychiatric conditions such as depression, anxiety, alcohol and substance use disorders. Despite their potential benefits, the risk of psychiatric adverse effects requires cautious administration.

Graphical Abstract