How Ozempic Could Help Mental Health Patients

Though it is early days, some medical practitioners working in the field of psychiatry are "cautiously optimistic" that weight loss drugs such as Ozempic could have benefits for those suffering from various mental health disorders.

Experts in the field who spoke to Newsweek explained there was a link between obesity and certain psychological conditions which the drugs may be able to help alleviate—though they said it was too soon to tell what effects on mental health semaglutide, which is sold under various brand names, including Ozempic, across the globe, could have, whether positive or negative.

"It's a significantly understudied area of science, and our populations and individuals with mental health [conditions] in general stand to benefit a lot from understanding the effects of these medications," Dr. Mahavir Agarwal, an assistant professor in psychiatry at the University of Toronto and a scientist at the Centre for Addiction and Mental Health (CAMH), told Newsweek.

It comes amid reports that some psychiatrists have been prescribing Ozempic to patients on antipsychotics and antidepressants to lessen the weight-gain side effects that are known to happen in some cases.

A series of magnetic resonance imaging (MRI) scans of a human brain. Researchers are using the scans to try to see if weight loss drugs improve cognition in mental health patients. Getty Images

Dr. John Buse, a medical professor and director of the University of North Carolina's Diabetes Care Center, who has worked on clinical trials of semaglutide for several decades, told Newsweek he had received a call from a patient in the past two weeks asking about just such a request.

"[With] antipsychotics, people can have 10, 20, 30, 50 percent body weight gain," he said. "I think that's what the crux of the matter is; I don't think anybody really thinks this is a first-line therapy for depression, anxiety, thought disorders."

Agarwal said that people with mental conditions were more exposed to weight gain and associated physiological problems as "there is inherent biological overlap; sometimes lifestyle factors are problematic or difficult to persist; there are system challenges—our systems could work better—but our treatments are also part of the problem."

"I'm not saying people should not be on anti-psychotics or antidepressants when they need them," he said. "I'm just saying they have side effects, and weight gain is a major side effect. And if they could have a medication strategy that could take away that side effect, leaving the mental health benefits, that's a good idea."

As such, weight loss drugs could very well help improve a patient's body image, making them potentially less likely to stop taking other medications that may be contributing to it.

Ozempic's Possible Side Effects, Good and Bad

Drugs like Ozempic have been heralded as a potential cure to an epidemic of widespread obesity and diabetes in many Western nations, which cause tens of thousands of excess deaths a year. Originally developed for diabetics, its use rose sharply in the first few years since receiving approval as people seek its weight loss effects.

But while its ability to reduce obesity and associated comorbidities has been demonstrated with a recently published major trial—in which Ozempic producer Novo Nordisk compared semaglutide to a placebo among 17,604 adults over the age of 45, and found it helps people lose an average of 15 percent of their weight and reduces the prevalence adverse cardiovascular events by 20 percent—questions remain about its potential side effects, both good and bad.

Psychiatrists say more research needs to be done to understand the full extent of what effects on the brain semaglutide has, but that there were early indications it and other medications like it may help with certain mental disorders.

Jamie Bennett, a spokesperson for Novo Nordisk, which produces semaglutide products including Ozempic, said the company "is continuously performing surveillance of the data from ongoing clinical trials and real-world use of its products and collaborates closely with the authorities to ensure patient safety and adequate information to healthcare professionals."

She added that the Food and Drug Administration requires weight management drugs that work on the nervous system to "carry a warning about suicidal behavior and ideation," but that this "had been reported in clinical trials with other weight management products."

Dr. Margaret Hahn, also a professor of psychiatry at the University of Toronto and a clinician at CAMH, told Newsweek that there had been more research done on metformin, a diabetes drug that also reduces appetite, and mood conditions such as depression and bipolar disorder, which had given "very nice preliminary data" to suggest that regulating metabolic abnormalities improved brain functions and reduced depression.

She and Agarwal are collating a study, which is still in progress and for which results have yet to be published, on whether semaglutide could improve weight and metabolism among schizophrenic patients who were obese and for whom metformin was not effective for weight loss—but is also using MRI scans to track changes in cognition.

Boxed of the diabetes and weight loss drug Ozempic rest on a pharmacy counter on April 17, 2023, in Los Angeles, California. Medical professionals are getting to grips with the possible side effects of the medication as its usage rapidly increases. Mario Tama/Getty Images

"If we see these effects with metformin, potentially with some of these more powerful weight loss and anti-diabetes medications, we may glean even better benefits," Hahn said. "It's too early to say, but we're cautiously optimistic."

She added: "Right now, the data's quite limited in terms of whether these medications have benefits on mental health." Hahn noted there were six randomized controlled trials looking at schizophrenia and the class of drug, of which theirs was one, "but they haven't been focusing on mental health benefits and weren't powered or weren't designed to do so."

Agarwal said that in the "limited clinical experience" they have had to test the drugs so far, they had not seen many mental side effects, but signs that semaglutide "might help a variety of mental health conditions."

Why Some Patients Can't Use Ozempic

However, there are physiological side effects to the drugs that can be experienced by some that may inhibit patients from using them. Buse said at the start of one of his semaglutide clinical trials, patients were excited about slimming down but felt "a little wrung out from losing that much weight that fast."

Other common side effects of the drug can include nausea and vomiting, though Hahn said: "What we find in general is, for most, these effects are transient and go away with time—and ironically, actually, anti-psychotic medications are used as anti-nausea medications in lower doses in cancer [treatment], so that can actually be a protective factor."

The attraction of Ozempic for those who are overweight and struggling with mental health conditions may be more simplistic, though. Buse said long-term studies suggested there was "some modest improvement in quality of life" for both weight loss and diabetes patients prescribed the drug.

"I get the sense that some people feel much more energetic after they've lost a substantial amount of weight; other people I think just feel good about having overcome this health issue for themselves," he said.

Note: The UNC School of Medicine has received funding to provide consultation services to Novo Nordisk, among other pharmaceutical companies. This work has contributed a small percentage to Buse's salary but has not changed or increased his salary.