GLP-1 RAs May Offer Both Metabolic, Mental Health Benefits

Background: People with diabetes and obesity have an increased risk of depression, anxiety, and suicide, reflecting a bidirectional relationship between metabolic and psychiatric illness. Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs) are widely used for metabolic conditions, but their neuropsychiatric effects remain uncertain, with prior data suggesting both potential benefits and risks. Objective: To evaluate whether GLP-1 RAs are associated with worsening or improvement of mental illness in individuals with depression or anxiety. Design: Nationwide register-based cohort study using a within-individual design. Methods: The study included 95,490 individuals in Sweden with diagnosed depression or anxiety who were prescribed antidiabetic medications between 2009 and 2022. A within-individual design compared periods of GLP-1 RA use versus non-use in the same individuals to reduce confounding. Outcomes were assessed using stratified Cox models, with the primary outcome de more...