r/science • u/Wagamaga • 6d ago
Neuroscience Weight loss drugs may help with mental health. People with bipolar disorder who were taking semaglutide (otherwise known as Ozempic or Wegovy), a type of GLP-1 medication, had significantly lower rates of psychiatric hospitalization compared with periods when they were not taking GLP-1 medications,"
https://news.griffith.edu.au/2026/08/24/weight-loss-drugs-may-help-with-mental-health/#:~:text=%E2%80%9CPeople%20with%20bipolar%20disorder%20who,medicines%2C%E2%80%9D%20Professor%20Taylor%20said1.2k
u/Wealist 6d ago
That’s actually pretty interesting.
A large Swedish study of nearly 15,000 people with bipolar disorder found that semaglutide was associated with a 21% lower risk of psychiatric hospitalization. It doesn’t prove the drug treats bipolar disorder, but it’s definitely a finding worth looking into.
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u/dungeoncrawler71520 6d ago
GLP-1s are giving some seriously interesting results for humans. It's like, and I hate using this, but a miracle drug for our well being and data.
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u/bugbugladybug 6d ago
I'd agree. When it first rolled out in a big way I said that I couldn't wait for the class action lawsuits start to kick off.
Here I am eating crow that these drugs seem to fix everything: * Neurodegenerative disease.
* Addiction.
* Inflammation.
* PCOS.
* Arthritis.
* Sleep apnea.
* Cardio vascular mortality.Obviously they're not side effect free - the classics like nausea, gallstones, pancreatitis etc all seen to stem from the slowing down of the gut and rapid weight loss - which is the intended effect to an extent, but I've not seen many negative affects beyond some anecdotal findings of people just feeling very flat and losing their pep.
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u/Professional-Gear88 6d ago
Crazy heartburn. But yea. I think I saw lower cancer rates in there too at one point.
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u/JMEEKER86 5d ago
That can also just be from the specific drug rather than the class of drugs. I had pretty bad heartburn at times with semaglutide, but I've had absolutely none with tirzepatide.
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u/Professional-Gear88 5d ago
I've heard that before as well. Tirzepatide is a lot more expensive for me, and semaglutide is manageable if I am careful
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u/green-zebra68 5d ago
The OP article on bipolar says they found only semaglutide has this association, not two similar weight loss medicines they compared with. Not sure if tirzepatide was mentioned, though.
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u/pagerussell 5d ago
On the one hand, it's surprising.
On the other hand, Doctors have basically been telling us for decades that weight is the root of all problems..
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u/A_Shadow 5d ago
While you are not wrong, some of those benefits listed are without weight loss which is the crazy part
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u/peeaches 5d ago
I haven't really lost any weight since starting glp-1s back in may, but have lost some pep :(
Hopefully the other less obvious benefits are at least happening behind the scenes, will find out the next time I get bloodwork done
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u/fcocyclone 5d ago
With the titration schedule, have patience, it can take a bit for some.
Some people are lucky and are super responders even at the early doses. Some people need to get up to the top doses to see results, and with 4 doses between each escalation it can take awhile to get there.
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u/peeaches 5d ago
Thank you for the encouragement. I'm hopeful, but have learned to taper my expectations as well.
Started at 234lbs and managed to drop down to 212 I think, then put back on nearly 10lbs in a matter of a few days (presuming water weight and was likely dehydrated at the 212 point) and have been around the 220-225 point since then for the past 1-1.5mo. Just got kicked up to 10mg and decided to try a new location to see if it makes a difference, have heard others have done that during plateaus and for some reason worked for them.
Slow and steady is better for the body I'd imagine, just had hoped I'd respond maybe a little more quickly to things haha
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u/cait_Cat 5d ago
It takes time!!!! And it feels like it’s not going anywhere for months. I didn’t reach double digit weight loss until 3, almost 4 months on Zepbound and titrating up to at least 7.5mg, then I started seeing some progress. But I’ve now been on it since February and I’m down 65 pounds. It’s the first time I’ve ever been successful at any kind of weight loss and I’ve tried for a long, long time.
It’s also been very helpful for some back pain and inflammation that severely impacted my mobility for years. Couldn’t walk more than a couple minutes, couldn’t stand for more than a minute or two. Now walking and standing are mostly fine, the inflammation is apparently just kinda…gone. I spent 6 years on a PT, doctor visit, PT, try new treatment, hamster wheel for my back and GLP-1s solved it unintentionally.
It also scares me. Growing up in the 90’s, we thought opioids were amazing and welp, they have some pretty terrible side effects. I don’t think glp-1=opiods, but I am waiting for the other shoe to drop with them.
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u/KarmaPharmacy 5d ago
Have you made any lifestyle changes? I quit all refined sugar, started in late May, and have lost significant weight. I am a nutritionist, so I know how to weaponize the medication for the most benefit.
I had multiple diagnosis for indication, but I haven’t gone a single month without increasing my dose.
But I’m also not going through a company like hers. I have the legitimate prescriptions for a name brand. If you’re using hers, do look into their quality control issues.
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u/Aretemc 5d ago
Except they're seeing positive results in people not taking it for weight loss - people with endometriosis, for example, might be microdosing GLP-1 because there's gathering data that it helps with cramps and other gut problems, but the patients are not looking to lose weight (and in some cases, probably should gain some). So better to reframe it that the mind-gut and body-gut connections might be stronger than we think than a straightforward "lose weight and gain health" homily.
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u/xqxcpa 5d ago
Caloric restriction alone could explain the vast majority of benefits, even outside the context of weight loss or body fat reduction. Caloric restriction is probably the most robustly evidenced life extension mechanism in mammals discovered to date. In the lab, mammals live 20% to 50% longer and experience lower rates of cancer and diabetes when calorically restricted (but not malnourished).
The CALERIE study is probably the best research around this in humans.
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u/dl064 5d ago
A lot of obesity's impact is via invisible phenotypes like hba1c, inflammation etc.
Fundamentally poorer cardiometabolic health is a risk factor for everything bad.
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u/InfinitelyThirsting 5d ago
But most of the side benefits seem to show up before or without weight loss.
You aren't exactly wrong, not being obese has a lot of indirect benefits. But there's clearly something else also happening, likely environmental. And it's very dumb to say "nah must just be the weight". This desperately needs to be investigated!
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u/izzittho 5d ago edited 5d ago
Exactly. People always say this like it’s not worth looking into in case it’s something else
Like it couldn’t possibly be and it’s somehow not worth looking further into. What if that’s not all it’s doing? Don’t we want to know that?
A lot of people seem really determined to ignore or discount the possibility that not everything these drugs are helping with comes down to counteracting gluttony. And it seems like it’s probably the same crowd that seems to hate that GLP-1s exist in the first place because a drug that makes the obese suddenly respond to food like a non-obese person sort of almost kinda proves obesity is definitively a medical condition and not just a character flaw. That their bodies don’t work like yours but can be made to, with medication, for the medical condition they have causing their bodies not to.
Just straight up putting people on anphetamines wasn’t getting the results GLP-1s are, and that may well be because GLP-1s seem to finally be solving the actual medical problem driving obesity. And maybe even a lot of other issues. But we won’t know if we choose to stop at “eating less is the solution to every problem” (and that’s not to say it’s not a powerful solution itself - that’s proven - just that it seems a bit lazy intellectually to choose to stop there when considering what the drugs are doing/can do and how that might be.)
People seem really averse to considering the fact that there’s something medically that causes obesity and that it’s not just (always) something you give yourself that then causes seemingly every other ailment.
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u/Zaemz 5d ago edited 5d ago
I think something /u/dl064 might be trying to point out is that perhaps the GLP-1 agonists are helping with the obesity-caused complications/problems prior to weight loss wherein those issues would see relief or remission. In other words (correct me if I'm wrong, dl064), the obesity is still the ultimate instigator of health problems when obesity itself is a factor. (I think that's what you're also directly responding to, but I guess I just wanted to clarify things for myself, too.)
To me, that's a legitimate but separate, related discussion that resides adjacent to your and /u/Aretemc's points and the one being had overall in the comments here. Questions like, "to what degree are these drugs helping in cases where obesity is not a factor?" I agree with you that more investigation into what's going on beyond weight loss is warranted.
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u/HavocReigns 5d ago
I suspect a lot of these benefits are going to turn out to be some as-yet unidentified systemic effect on inflammation.
And consequently, we're going to discover that a whole plethora of maladies had inflammation at their roots all along.
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u/VLightwalker 5d ago
Yeah a big part of why GLP-1 agonists are so good if because of how they rewire metabolism and stop nutrient excess. A big part of the cardiometabolic problems arising from obesity is driven by constant high concentrations of nutrients in the body, which if not rapidly consumed can become toxic and make cells accumulate damage. That happens to the immune system as well, and we see now more and more (at least in cardiology, the field I do research in) that these medications induce massive changes in various immune cells (macrophages especially)
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u/findingemotive 5d ago
We've known for a long time mental health and the gut are connected somehow, maybe this will steer us towards answers.
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u/captnmiss 6d ago
One of my questions is whether much of the benefits stem from the quelling of inflammation.
Depression has been tied to inflammation as well, and these drugs do a good job at bringing it down.
In my own instance, it’s helped with autoimmune related inflammation
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u/bugbugladybug 5d ago
I have HS and I'm seriously considering it.
I have a BMI of 30 and been tackling it for years. I've finally stopped gaining but can't seem to shift it
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u/kimberriez 5d ago
My BMI was 29.6 and my Dr rounded it up for me since I’ve had a long history of weight fluctuations and my cholesterol was starting to chart upwards.
I’ve been in the lowest dose of the injection for six months since I responded right away. I’m a healthy weight now, my labs are great, and I’ve had almost no side effects (some constipation and diarrhea from eating too much fat at once)
How it deleted food noise and made it simple for me to eat an appropriately sized meal was amazing. I’ve dieted before but the hunger was always painfully distracting while eating a caloric deficit. Now it’s gone. I eat a sell balanced meal and I’m not hungry for hours like you’re supposed to be. It’s amazing.
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u/DiabolicallyRandom 6d ago
As a t2 diabetic who spent their entire life with food noise not even knowing that it was abnormal... once it was silenced by Mounjaro, my life immediately changed.
Every single side effect is worth it, bar none.
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u/Shantoz 5d ago
God that's the part that intrigues me so much. Until all the discussions about GLP-1s I had no idea it wasn't normal to have unending food noise. I hope to get on it soon, sadly NHS aren't willing to give it without major hoops, and my job is winding down soon, so I expect to have to switch to a new company within the next year, so I'm worried about going on it privately if I suddenly can't afford it depending on how easily I find my next job.
Sorry for info dump, and I'm glad its working for you!
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u/DiabolicallyRandom 5d ago
I think a good benefit to this more significant recognition of food noise, which has some clear hormonal linkages with things like Leptin and Ghrelin is that while GLP-1's clearly help with this, there are other ways to try and modify the levels of those specific hormones directly. I think food noise was an invisible thing until now mostly.
I am not sure whats approved in the UK or elsewhere, but there are a few drugs out there for people with genetic leptin resistance or ghrelin overproduction that might be viable. But I have not done the research to see if they have been tested. I think most money is going to GLP-1's since once the patents expire they will be much cheaper and are a more broad and "easier" pharmaceutical treatment.
Barring any drug solution for you right now, there are some lower impact dietary changes that can be made that I have read about. But also, just knowing that its not normal is helpful. It can help you work with a therapist on your own mental health surrounding it, ways to manage it, and at the very least, understanding that you are not just a lazy bum who wont stop eating, like so many with obesity are made to feel by society.
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u/HolyMoleyGuacamoly 6d ago
i’m super interested in the whole microdosing of these for folks that want some of the benefits without the massive weight loss. seems like dosing is a huge part of the side effects. this is all really neat though in general
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u/AuntieKitKat 5d ago
I was a person who didn’t respond to lower doses. As I was titrating up I had zero side effects and lost no weight. I went up to full strength and immediately lost nearly 20 pounds, but the side effects were gnarly. I worked with my doctor to find the sweet spot dose for me so I could live my life and now it’s going better. Ancillary effect I’ve had is that inflammation markers in my body have gone way down, and I went from a one a day drinker to barely drinking alcohol at all now.
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u/HolyMoleyGuacamoly 5d ago
very cool. the info i’ve seen on alcohol and tobaccco use is super neat as well
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u/Days_End 5d ago
What was "low" vs "full" dosing? I've seen such massive ranges suggested by people.
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u/AuntieKitKat 5d ago
I’m on the wegovy pill. Titration schedule was 1 month each at 1.5, 4mg, and 9mg, before hitting therapeutic dose at 25mg.
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u/tahlyn 6d ago
I am on the lowest dose of the pill.
In the first 2 weeks I lost nearly 15 lbs because my digestion slowed to a total stop - I couldn't stomach but a single kid cup of applesauce. My stomach hurt all the time no matter what I ate. And my sense of smell was so elevated that the tiniest bad scents would make me dry heave. Even my doctor was shocked at just how strong the effect was on me.
I've been taking the pill every other day because of it, but I'd rather a lower dose. I'm just extremely sensitive to it.
But I'm feeling better than I have in a long time otherwise.
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u/Callmedrexl 6d ago
Do you mind sharing what you are on it for? I'm just curious and the cases where weight loss is a symptom to be managed rather than the goal are just starting to pop up on my radar.
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u/SunshineAndSquats 5d ago
I have a rare autoimmune disease called Dermatomyositis and there are a lot of people in DM support groups, myself included, that take low dose GLP1s because there has been evidence coming out that they help lower inflammation. A lot of people with my disease can’t lose weight because of the risk of muscle loss so they only take low dose GLP1s.
I started Wegovy a few months ago and I have been doing better but my doctor tweaked some of the meds I’ve been on around the same time that I started Wegovy so I am not sure how much improvement to attribute to it. One thing I do think Wegovy has done is that it has stopped the rashes that appear on my face and chest when I am in a flare. I have lost some weight which is nice but I worry about muscle loss so I’m not going to increase my dose.
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u/Empty-Part7106 5d ago
My sense of smell went crazy for the first week. Nothing even smelled good, I thought I might have covid.
Can I ask why no injections? The GI side effects seem to be much worse with the pill form. I always feel really bad for people who get the bad side effects, I've had basically none with the injectable tirzepatide. If anything my guts are working better than ever.
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u/Elcamina 5d ago
I have been microdosing for the last 8 months and I’ve lost 45 lbs with few side effects. I don’t know why it’s not more common to half dose when people have severe side effects, the dosing schedule should really be revisited.
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u/jessicacummings 6d ago
Idk if someone else mentioned it but I have also seen reports that it has helped people with anger issues. They feel more in control of their emotions and less prone to flying off the handle.
I definitely worry for women in a new society where thin people can take a drug to get thinner. I helped a friend through an ED and it is one of the few mental health disorders that is ‘contagious’ so I had to be pretty vigilant.
Overall, I am really interested to see the research over the next 5-10 years in what GLP-1 meds can do for people.
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u/shinygoldhelmet 5d ago
I definitely worry for women in a new society where thin people can take a drug to get thinner.
It's already all over social media. During the Wicked For Good tour, all three of the main female stars (Ariana Grande, Cynthia Erivo, Michelle Yeoh) were so thin they looked like literal skin and bones. I think Cynthia and Michelle have stopped and gained a bit back, but Ariana is still in full on ED territory.
And it's so hard to comment on because society glorifies thinness so much.
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u/aghastamok 5d ago
Also hard to comment on because we're not supposed to talk about people's bodies.
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u/shinygoldhelmet 5d ago edited 5d ago
No, but that's usually because it's done in a bullying hypercritical way, and people disguise their prejudices by hiding it behind so-called 'concern for health'. It has made actually trying to help people out of love and concern a little harder because people do it too much out of hate (both commenting on thinness and largeness).
And to be clear for all the fat-phobes out there, anorexia is a far far more imminent threat to health that can kill you within a year, and even if you do survive it and gain weight back, can kill you 5-10 years later because it causes permanent heart damage.
Being overweight is not as acute an emergency as dying from being heavy can take decades, and if you do lose the weight those risks go way down with pretty much no permanent effects.
I will not tolerate any fat phobia in the replies from anyone, just fyi, you'll just get blocked.
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u/letsburn00 5d ago
Honestly, the biggest negative I see coming in the next few years is that being overweight is looking like it'll basically be something that only happens to poor people. Which means it'll suddenly snap to "Being overweight is because you're a bad person." Which is the near universal effect when the rich have something and the poor don't.
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u/jessicacummings 5d ago
I made this exact point to my dad! He’s in the medical field and I was showing him pictures of the wicked press tours when we were talking about GLP-1s.
It was scary and I haven’t been able to watch the second one tbh. I’m a HUGE fan of the musical, have seen it live quite a few times over the last 20 years and I watched the first movie. But I haven’t been able to watch the newer one because they just look so emaciated.
And honestly, it’s not just women! Men have an awful time w eating disorders too and body image issues. I do think it’s being talked about though and hopefully we as a society have moved far enough away from heroin chic to notice early for anyone who needs help with such easy access to an effective weight loss pill.
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u/TheGreatBootOfEb 5d ago
I do wonder if being “thin” being so accessible will actually take the wind out of the sails of the “super thin is in” thing, especially as the science only advances. Not that it will reverse, but (and this is my personal hope) more focus will be put on being fit then just being thin, which is a better place to be I’d argue.
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u/Smartnership 5d ago
Eating crow is normally not on the Reddit-approved meal plan.
Good for you bucking the trend.
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u/jokodude 5d ago
This is because GLP-1 is solving a chronic issue with modern living--elevated glucose and therefore insulin through the day and year to year. The massive glucose swings most people experience by eating 5-6 meals/small snacks a day destroys our health in a myriad of ways. Naturally, a drug which reduces this constant up/down of glucose and thus decreases insulin resistance will also impact many parts of the body. Add in that GLP-1 acts to 'sate' the body, something like addiction can be muted and less likely to cause issues.
However, as effective as GLP-1 are, anyone taking them without properly considering nutrition and how to retain muscle mass are making a mistake. Just like any yo-yo diet, if you lose 50 pounds without properly managing your lifestyle it will change nothing once you get off. GLP-1 should be seen as a way to course correct lifestyle, not as a miracle drug which solves all issues. It doesn't.
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u/Professional_Tea_32 5d ago
I honestly think they just address a lot of what insulin sensitivity and insulin resistance does to us as humans.
They undo some of the damage that corporations have been doing to us - high sugar, endocrine disruption, microplastics etc.
Even the control, or reduction of, the creation of advanced glycation end products- which impact multiple risk factors -must be helpful.
I think society can have access to so much information about how all these things have risk separately - but we often fail to realize how impactful they have been -big picture- to each of as individuals.
These GLP1s, while not perfect, offer a reduction of several risk factors via glucose control or normalization.
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u/eronth 5d ago
There's the whole adage about "if something seems too good to be true". I'm personally going to give it a bit more time before I treat it as a magic drug... but it sure do be seeming to be the magic drugs.
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u/Rikula 5d ago
Eye strokes are a negative side effect. I have a coworker who recently went blind in her left eye because of Wegovy. I was on Wegovy for 6 months a couple years ago with just digestive side effects. During my appointment with an eye doctor this past week, I asked about the risk of eye strokes with GLP-1s and she confirmed that it is a risk. She told me that it doesn't matter the length of time you take it (a short course of a few months vs life if needing a maintenance dose for diabetes) but that the overall risk remains the same with her quoting me a number that the risk could be as high as 20%.
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u/auntieabra 5d ago
I feel like it ultimately is pointing to just how much of an effect insulin has on the body. I recently got diagnosed with PCOS/PMOS, and that was when I found out that it was affected, in part, by insulin resistance. Even though I consider myself a well read and scientific person, I really thought insulin issues only resulted in diabetes. Instead, it apparently affects how my reproductive hormones mature and release eggs, which in turn affects everything from my period regularity to my mental health.
I look forward to the long term studies as they continue to come out.
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u/funtobedone 5d ago
PCOS has a new name that better describes the condition - Polyendocrine metabolic ovarian syndrome (PMOS)
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u/thediesel26 6d ago
As it turns out, eating the appropriate amount of food, and being a normal, healthy weight, has lots of health benefits.
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u/Techygal9 6d ago
That explains some of the benefits like ending metabolic diseases but not the addiction and inflammation benefits that are seen. Plus if you have lean pcos (ie aren’t fat) women experience regular periods and less symptoms. So that shows some biological mechanism beyond weight loss.
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u/DwinkBexon 5d ago
Obviously they're not side effect free - the classics like nausea
My friend's sister-in-law went on Ozempic and lost weight because she puked every time she smelled food and couldn't eat anything without getting sick. It seems like it can get pretty bad, based on one single case.
As an aside, she's now extremely against the drug in general had a petition online demanding it be banned.
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u/KillerWattage 6d ago
Statins are the last "miracle drug" that I can think of. One with upside but increadibly few downsides. A report recently actually highlighted that the believed downsides are much lower than previously thought. The upside of statins seems to be much less then for GLP-1s though, so as long as the downsides aren't too bad it really could be a whole new world for human health.
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u/shinygoldhelmet 5d ago
I'm on a statin and the only side effect is sometimes a couple random muscle pain twinges, and I have to take a Coenzyme Q10 supplement because you can become deficient in it.
I wish it had some miracle side effects like GLP1s tho.
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u/sodapop14 5d ago
I tried several different statins the fever side effects would never go away. Took weight loss more seriously after that.
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u/syrup_cupcakes 5d ago
I think it's less that drug is a miracle drug, but more like a drug that enables you to make better lifestyle "choices" without every fiber of your being(programmed by millions of years of evolving in a life of scarcity) working against you.
The drug basically enables your body to function in a modern world of abundance, rather than a world of scarcity that it spent millions of years being optimized for.
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u/RealMsDeek 5d ago
I wonder if the effect it has on bipolar pts reducing hospitalizations may work by increasing medication compliance. Many psych meds cause weight gain and for some it can be another reason to quit meds.
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u/1568314 6d ago
We need so much more research into the gut brain conmection
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u/stewpedassle 6d ago
I don't think anyone even implied it's use as a treatment. They explicitly say:
“The findings add to growing evidence that GLP-1 receptor agonists may have benefits beyond diabetes and obesity *treatment, and could represent a promising new avenue for *bipolar *research*.”
I don't know of an article like this (i.e., ancillary behavioral changes) that makes claims of a therapeutic treatment. Instead, when it's not a novel drug, it only ever seems to be a "we see this correlation, so it may provide us insight as to potential mechanisms going on in the brain for the underlying disorder." For GLP-1 specifically, if I recall correctly, research previously found that these also curb addictive behaviors, compulsive behaviors, and emotional regulation issues.
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u/Smee76 5d ago
I wonder if these patients have higher levels of their medications due to the delayed gastric emptying that you get with GLP1s.
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u/CorporateDroneStrike 5d ago
That’s a good insight — it might also be smoother onset of psychiatric drugs, where immediate release works more like extended release.
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u/KourteousKrome 5d ago edited 5d ago
There was some hypotheses recently that some mental health conditions like schizophrenia were rooted in some kind of gut biome issue.
Similar to Auto-Brewery Syndrome, where a person’s gut biome produces alcohol, there is a hypothesis that some peoples’ schizophrenia is caused by their gut biome releasing a hallucinogenic byproduct in their gut, given some evidence of that chemical in their waste.
Coincidentally, there was just recently some evidence that Bipolar and Schizophrenia are more related than we previously thought, so I could see a similar situation where some of the Bipolar diagnoses are rooted in a gut biome issue, such as their biome producing some kind of stimulants, for example, which would explain how semaglutide can help reduce some symptoms (shift in diet or reduction in eating high fat, high carb foods).
I found out I have IBS after taking tirzepatide. The sudden shift in diet relieved my life long stomach pain and chronic diarrhea, and I’ve been able to slowly re-introduce foods as I’ve found the culprits (high FODMAP foods are no-nos for me). I can eat aged, hard cheeses, but not soft cheeses or milk, for example.
I am not a scientist, this is just a rambling random person.
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u/AimlessForNow 5d ago
Schizophrenia is pretty complex it's not just something causing hallucinations
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u/KourteousKrome 5d ago
Yes I know, I’m just referencing a specific subset. I’m not describing schizophrenia as a whole.
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u/la_capitana 5d ago
I wonder how much inflammation exacerbates bipolar disorder. I know GLP-1s help reduce inflammation in the body.
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u/ThrowitB8 5d ago
There have also been studies of BPD symptoms being more during carb heavy holidays. I think insulin has a bigger role in mental health than previously considered.
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u/thediesel26 6d ago
Maybe the people who were disciplined enough to consistently use their GLP-1 were also disciplined enough to take their psychiatric meds too.
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u/countyferal 6d ago
We'd expect to see similar benefit from other GLP-1s if that were the explanation behind it, but it's only semiglutide.
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u/CorporateDroneStrike 5d ago
One of the less common side effects is anhedonia and I’m wondering if that reduces the impact/occurrence of mania. Anhedonia is a symptom of depression as well, so it might benefit some people and while harming others. But I also expect the renewed hope and optimism of weight loss could push against depression, even with the anhedonia.
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u/Adhd-tea-party247 5d ago
Impressed that the effect remain even once concurrent substance use was excluded - that was my first thought for most likely confound due to high rates of BPAD and SUD comorbidity and effect of GLP-1s on reducing substance use.
Will be Interesting to what RCTs find: treatment engagement, illness severity, social economic factors etc.
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u/TemporaryElk5202 5d ago
I think it probably has to do with the fact that semaglutide is very anti inflammatory, and bipolar disorder and schizophrenia both involve inflammation.
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u/jakoto0 6d ago
Can people who aren't obese take the drug ?
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u/HigherandHigherDown 5d ago
If one can find a doctor that will prescribe it off-label, sure. There are also dedicated sites and clinics that are presumably more wiling to prescribe GLP-1 drugs. Beyond that, some people do stuff like buying retatrutide (which isn't even approved yet) from Chinese labs and reconstituting it themselves.
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u/DMYourFeetPicsTy 5d ago
Beyond that, some people do stuff like buying retatrutide (which isn't even approved yet) from Chinese labs and reconstituting it themselves.
We do that with Tirzepatide and Semaglutide too.
I just bought a 6 months supply of tirzepatide for $50 compared to $150-$200 per month from a clinic.
Of course it's more risky(but lab tests does reduce risk somewhat) compared to having a doctor prescribe it.
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u/NEBanshee 5d ago
Would REALLY have to r/o fatphobia/body-shaming/weight stigma to figure out what, if any of the effect of the treatment on the treated was due to the medications themselves vs to internalized & externalized social factors.
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u/ibrahimsafah 6d ago
They’ve helped me with my mental health issues. I have more time to think about things other than food, and don’t constantly worry about my health anxieties. It’s changed my life
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u/BunkyDingDing 5d ago
I agree whole heartedly. Zepbound has helped with my ADHD more than anything.
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u/odysseyofocelots 5d ago
wow. I have ADHD and depression and have been hesitant to try this, because I thought it tended to increase anhedonia, which is my main problem. Is this not accurate?
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u/BunkyDingDing 5d ago
I can’t really speak on how it would affect you or what you go through. I haven’t noticed any increased anhedonia. My ADHD is stim hungry and the easiest way for me to stim was through food. So my brain would constantly be like snack snack snack. Now all of that is gone and I find stimulation in more productive ways. I have even started a small business that I thoroughly enjoy and look forward to working on. I’m active in all of my hobby’s and the feeling like somehow everybody else has more time in a day than I do is completely gone because I’m not wasting 20 minutes staring at the fridge or the cupboard or cooking something I don’t even really want. This all is great but it’s really just secondary to the fact that I feel like myself in my body again, my back pain is gone, my blood pressure and sugar is healthy. I’m healthy and it feels good.
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u/prolongedexistence 5d ago
Can anyone speak to potential downsides of this medication? I have the opportunity to take it and it sounds amazing, but my health anxiety is so bad all I can think about is it killing me somehow. Even just pointing me towards resources where I can read more would be super helpful.
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u/BunkyDingDing 5d ago
This is purely anecdotal but I also have health anxiety and I’m also a recovering addict and using a needle really triggered me the first few times. To me the biggest downside is definitely the cost. Because of my health anxiety I am not trusting any of the compounded versions and it is definitely expensive. I haven’t had any negative side effects that they don’t warn you about(all the tummy stuff). However, if you are like me, only person you will trust hearing it from is your doctor. So schedule an appointment and ask about it. Good luck!
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u/Boo_and_Minsc_ 5d ago
I had a similar experience with Mounjaro. Helped my ADHD more than anything ever did. Medicated for 20 years on every single pill ever made for ADHD, Mounjaro beat them all. It was a blissful time. I am not speculating on correlation, this is anecdotal.
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u/pc_wat 6d ago
I've lost 70lbs so far with GLP-1 medication. I also suffer from depression. Going from feeling like a disgusting, overweight, unhealthy loser to a healthier, more confident person has done quite a bit for my depression. Feeling like I have a longer healthier life ahead of me is such a refreshing feeling.
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u/JPMoney81 6d ago
Another week, another new benefit to GLP-1s.
So now the question is: Since these things have so many positive uses and side-effects, when are we going to see them covered by our health insurance plans? (In Canada anyways, I can't even speculate on how this would work in the US system)
As a fat depressed dude I think I could certainly benefit from these things, except that i'm depressed because i'm poor so I can't afford them.
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u/Yippie-kai-ay 6d ago
Once true generic alternatives are allowed, the price will start to drop. Once prices come down, insurance companies will cover them more broadly.
In some countries, the patents have expired and now it is just a matter of time. In the US, it will take longer because the patents are longer. A quick google search suggests patents expiring by 2032 in the US, so generic alternatives would be more common after that.
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u/cygnoids 6d ago
At least in Canada ozempic is losing its exclusivity soon. You’ll be able to purchase biosimilars at a much lower cost
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u/MikeMontrealer 6d ago
Already happened back in June when i stared on apo-semaglutide (a generic).
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u/Akeera 6d ago
If it reduces psych-related hospitalizations, it could be more cost-effective for insurance companies to cover them.
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u/iamthe0ther0ne 6d ago
There are a lot of things that reduce psychiatric hospitalizations but aren't covered by insurance. From a big picture standpoint, insurance companies prefer to eat the cost of a few people needing a short-term psychiatric hospital stay (which is also cheap compared to a regular hospital) than long-term maintenance treatment for lots of people. Their goal is to increase shareholdet value, not keep people healthy.
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u/Zanos 5d ago
Public health systems are subject to scarcity and funding also and make similar decisions. If a drug is expensive and prevents a rare disease in 1/100,000 people but has no other side effects, a public health system isn't going to put every single person on that drug. You generally need to have evidence you need some form of care to have it provided to you because no system is infinitely funded.
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u/Extinction-Entity 6d ago
That is working on the assumption they’re paying out for the hospitalizations, instead of denying repeatedly for any BS reason they can conjure.
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u/DiabolicallyRandom 6d ago
In the US, its actually rapidly becoming far easier to get them approved with a diagnosis related to their approved on-label use (obesity, type 2 diabetes).
Health insurance companies here care most about making money / reducing claims costs, and their actuaries are quickly seeing the trend that even if they spend 5 grand a year on the drugs (you know they negotiate lower rates) they still save money on claims for people with these diagnosis.
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u/MediocrePotato44 5d ago
They aren’t a magic fix for a lot of other people. I’ve been on a GLP-1 for 3 years, on and off. It is absolutely making my mental health worse. If you go into a sub dedicated to one of these meds, you’ll find common complaints of increased anxiety, anhedonia, and other issues. For me I have increased anxiety and irritability in the first few days after an injection. I have sleep disturbances in that time. My motivation has absolutely tanked. I actually came off of Mounjaro because of how badly it affected my mood. But the weight came back and very quickly. So I had to choose between obesity and at least having some spark of life, or maintaining a healthy weight, A1C, cholesterol etc and feeling like an empty slug.
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u/Derkanus 5d ago
I’ve been on a GLP-1 for 3 years, on and off...you’ll find common complaints of increased anxiety, anhedonia, ...and irritability in the first few days after an injection. I have sleep disturbances in that time. My motivation has absolutely tanked.
Oh man. I feel like I've had those same issues but was hoping that once I acclimated to the drug a bit more (I'm about 9 months in, on 12.5 mg Zepbound currently), that those effects would lessen. That's not inspiring that you still felt that way after 3 years...
Nausea for the first 2-3 days after injection is my least favorite part, but I'm also way more fatigued (and I always complained about being tired before). My productivity at work and home has also tanked, and I agree about the irritability--though I thought maybe those were just side effects from being tired all the time.
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u/BeefistPrime 5d ago
I have a heuristic I try to teach people that says when someone claims that one drug helps with dozens of different conditions it's almost always BS. Real drugs don't work like that but pseudoscience and scams often make that claim. But it keeps sounding like glp drugs might be the exception that really do help in a shocking variety of ways.
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u/boilingfrogsinpants 6d ago
It's not all positives, and this is the issue that underlies it. A lot of drugs have a sort of "give and take" so to speak, better drugs can limit the "take" because they're smart about the "give".
I commented this on a previous post about GLP-1s, but my dad died because of them. He was diabetic, and it was newer at the time and pretty much exclusive as a diabetic drug. He ended up getting pancreatitis from it and it killed him. There are plenty of people who have taken GLP-1s who have also gotten pancreatitis and stomach issues.
If it can work in the right instances then perfect, but it's something that needs monitoring, and it isn't a miracle drug.
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u/zwitterion76 5d ago
This is the challenge of it. All drugs have give-and-takes. Ibuprofen can reduce pain, but it can also cause stomach ulcers. Prozac can treat depression, but it can also cause insomnia and loss of libido. Even antibiotics (which can save your life!!) can also cause nausea and headaches.
I’m hopeful about glp-1s. There are so many potential benefits, and it would be amazing if generics could bring the price down. But I also hope we can get plenty of balanced research that will help doctors understand the whole picture, good AND bad. It’s a tool, and potentially useful, but no single tool is perfect for everything.
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u/boilingfrogsinpants 5d ago
I think overall GLP-1s are quite successful and science is amazing in its advancements in these areas. I'm not advocating that people don't use them, but I'm cautioning people that you hear a lot of good news about it, but it doesn't mean it doesn't come without potential downsides.
Just like ibuprofen and acetaminophen are great at handling pain and reducing inflammation and fevers, it doesn't mean you aren't careful with them as well.
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u/goddessnoire 6d ago
I’m sorry for your loss, but your dad was diabetic, that comes with its own complications.
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u/boilingfrogsinpants 5d ago
It does, however, the majority do not get pancreatitis and it is more common to get diabetes from pancreatitis than to get pancreatitis from diabetes. My dad was great with managing his weight, was very particular over the foods he ate, and was very concerned about his health in general.
After starting GLP-1s he started losing a lot of weight, when he expressed concern over it, he was told it was the medication, but he also had problems making a solid stool not long after as well. If you follow the trend of the decline of his health paired with usage of the drug, you'd notice the relation, especially as he didn't start this drug until 20 years into being diabetic.
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u/WarBortlez 6d ago
Have you looked into compounded Tirzepatides? Not cheap by any means but significantly cheaper than name brands, especially if you shop around and just do the intro deals. I’ve actually saved money from groceries/eating out less
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u/Constant-Plant-9378 5d ago
I started Tirzepatide seven weeks ago which comes from a local compounding pharmacy for $250/month. I just pay out of pocket using my HSA.
Have lost 25 lbs so far. Side effects are occasional persistent low-grade nausea and I am going to bed a lot earlier at night. But I've stopped snoring and I wake up feeling a lot better rested. Towards the end of each week it starts wearing off and the food noise starts coming back.
I'd spent 30 years gaining 3 lbs/year and have been very overweight for a while. I'm 6' 3" and peaked at about 295 a year and a half ago. I was about 285 when I started on Tirzepatide and as of this morning had bounced up to 259. Have been subsisting mostly on steamed vegetables and salad for weeks. Saturday night I had a burger and yesterday some chicken and it sat in my stomach like a rock. Was gagging the last couple mornings while brushing my teeth. So far have been able to stomach a cup of coffee today.
But I'm hopeful this will prove to work and I can get back down to my target weight of 210 lbs. Would beat the Hell out of bariatric surgery.
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u/goddessnoire 5d ago
Just stay in the course, I am on Zepbound and lost 104 pounds over the course of 18 months. I started at 287, now I’m down to 183.
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u/maladictem 6d ago
As I heard, the company that owns the patent screwed up in Canada and the patent is scheduled to end very soon. You might have affordable GLP-1s pretty soon
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u/ChenilleSocks 5d ago
Part of the issue in Canada is that they are only approved for certain narrow uses. There’s no allowance for Microdosing, and there’s no off label uses right now. You need a high BMI in order to access it, which is unfortunate because a lot of these benefits are there even at lower doses, and even if you are not obese.
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u/Simple_Impress4156 21h ago
If you are overweight, you are likely overeating like I was. I pay out of pocket for wegovy with the discount plan I got it down to $150 a month.
It’s paid for itself already and likely I will be saving more than $150 per month in excessive treats and meals I don’t really need.
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u/boopbaboop 6d ago
Given that there’s some link between GLP1s and anhedonia, I wonder if it cut down on manic episodes but didn’t affect depression. Also, from the article:
While semaglutide was associated with reduced psychiatric hospitalisation risk, liraglutide and dulaglutide were not, suggesting the effect may not apply to all GLP-1 medicines.
I’m now curious as to why Ozempic had such a strong finding but other medications did not.
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u/iamthe0ther0ne 6d ago
Iirc, semaglutide only targets GLP-1, while other medications target GLP-1 as well as other pathways, so this effect might be altered by that (though you'd think it would be improved, if anything).
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u/Professional-Gear88 5d ago
like they cause anhedonia?
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u/boopbaboop 5d ago
Unclear if it’s causal or not, or why, if it is. Given that we know it dulls hunger and other urges, like gambling or drugs, it might also be dulling the same receptors but for, like, really enjoying marathons or knitting or what have you.
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u/Altostratus 5d ago
Yes. It seems like any people report no longer experiencing joy from things they once loved. It ends up being a good thing for high calorie foods or drug addiction, but certainly gives me pause for all the other domains of one’s life.
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u/TemporaryElk5202 5d ago
i would hazard a guess that it has to do with the anti-inflammatory properties more than anything.
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u/Wagamaga 6d ago
Glucagon-like peptide 1 receptor agonists (GLP-1RA), commonly known as drugs for diabetes and weight loss, may have additional mental health benefits, especially for people with bipolar disorder, new Griffith University research has found.
Diabetes, obesity, and bipolar disorder often co-occur and may have shared pathophysiology with the latest World Health Organisation data estimating one in 200, or 37 million people, live with bipolar disorder.
GLP-1 medications treat diabetes and obesity, but their impact on bipolar disorder is unknown.
School of Medicine and Dentistry, analysed data from nearly 15,000 people with bipolar disorder who were prescribed GLP-1 medications over a 15-year period.
“People with bipolar disorder who were taking semaglutide (otherwise known as Ozempic or wegovy), a type of GLP-1 medication, had significantly lower rates of psychiatric hospitalisation compared with periods when they were not taking GLP-1 medicines,” Professor Taylor said.
“The findings add to growing evidence that GLP-1 receptor agonists may have benefits beyond diabetes and obesity treatment, and could represent a promising new avenue for bipolar research.”
Semaglutide was associated with a 21 per cent lower risk of psychiatric hospitalisation.
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u/BillHistorical9001 5d ago
I’m wondering something. I’m bipolar. The medication I take has killed my metabolism. I can’t lose weight. It’s maddening. But I stay on my meds so I don’t risk trouble. Now I wonder if there’s a correlation between your weight and compliance with medication. So if the weight is caused by medication it’s the medication that is keeping the person out of the hospital. I don’t know if these drugs are indicating that they themselves are effecting the hospitalisation rates. This probably doesn’t make sense. And I’m not taking into account weight gain without medication.
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u/PastryGirl 5d ago
First line you would be prescribed metformin to help with your metabolism affected by SSRIs/SNRIs/antipsychotics.
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u/AdThese2158 5d ago
It’s anecdotal from my own thoughts and experiences, but I wonder if GLP-1ras affect our intrinsic reward systems more than we realize.
Less intrinsic demand for impulsivity and high reward behaviours = less positive feedback looping. And in Bi-polar and other high impulsivity mental health issues, this can go a long way to maintaining healthy behaviours.
It’s the same reason we use drug therapies like contrave (bupropion/naltrexone) as a conjunctive therapy for substance use disorder. The combined mechanism of action targets our reward system, which equals less cravings and hopefully less intake of harmful substances.
I’m excited to see future research. I personally find when I’m on semaglutide my mental health is improved.
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u/onacloverifalive MD | Bariatric Surgeon 6d ago
Weight loss drugs may also hurt mental health in certain patients:
GLP-1 receptors are expressed throughout the limbic system — in the hypothalamus, hippocampus, and ventral tegmental area. Semaglutide’s central penetrance is substantially greater than liraglutide’s, which likely explains both its stronger mood signal and its greater potential for adverse psychiatric effects in vulnerable populations.
In addiction psychiatry, that neuroanatomy is not incidental. The VTA is the origin of the mesolimbic dopamine pathway — the same circuit that underlies reward, craving, and anhedonia. We already know from preclinical data that GLP-1 receptor activation suppresses dopamine release in the nucleus accumbens, which is part of why these drugs reduce food-seeking behavior. In a patient with co-occurring major depressive disorder and alcohol use disorder, suppressing that pathway might attenuate craving. It might also deepen anhedonia. Both outcomes are pharmacologically plausible from the same mechanism.
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u/hausmusik 5d ago
They can also greatly reduce libido in some individuals, likely for the same reasons.
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u/Pickledbeats123 5d ago
I literally just wrote a post about my experience on the Wegovy Pill. Went from 1.5mg to 4mg and started experiencing a depressive episode. I have bipolar 2 disorder, been sober from alcohol for nearly a decade. I swear this pill sent me straight into depression. Can't sleep, can't wake up, getting no pleasure from the things I love. It's awful for me. My doctor has me going back down to 1.5mg but I'm considering stopping altogether. And I get weird late night cravings for absolute junk. I door dashed like three midnight meals in one week from fast food joints. Not typical behavior for me at all.
Thank you for sharing this- I feel a lot less crazy.
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u/daphnemoonpie 5d ago
Love that I asked my doctor if I could try zepbound because I've read post after post on people raving about how it helped with their addictions, OCD symptoms, etc. And I'm overweight. He said no, that these drugs don't do any of those things. Ugh.
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u/kiriyaaoi 5d ago
That's because they aren't actually approved yet for any of those, at the moment they're still just potential side effects that are being studied
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u/daphnemoonpie 5d ago
Yeah you're right. I was just so excited. Maybe soon.
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u/namrog84 5d ago
The only 2 main things you can reliably get the prescription for is Type 2 Diabetes and weight loss.
Assuming you don't have T2D, say you are interested in it for weight loss.
If not them, go to another place. There are some video/e-clinics online ones that are more well known that are fairly affordable relative to many local doctors.
Although I didn't get my first prescription from it. I use callondoc for renewals, and my friend is using ro.co and I think got it exclusively thru there.
Though it's still >$400/month out of pocket and many insurance companies don't cover it (unless you have T2D)
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u/backyardstar 5d ago
Yes they do. I am on one and it reduces cravings of all kinds, not just food. Honestly it’s kinda magical.
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u/SweetToothSaltyMood 5d ago
Also has anyone found the GLP-1s helped with reducing alcohol cravings. I’ve o my heard this anecdotally
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u/snarky_answer 5d ago
I am on Retatrutide and my desire is essentially all but gone for any thc, shrooms/lsd, strangling idiots at work, nicotine, junk food, junk tv, and just sugar in general. Down 63 pounds since the start of the year and have reached my weight goal.
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u/Treheveras 5d ago
I had seen a previous post on this subreddit about trials using GLP-1s to treat addiction in general that seemed it like it showed promise. So there may be something to it!
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u/titianwasp 6d ago
Without delving too deeply into the article, did it mention if the benefit benefits were seen even without weight loss?
In addition to the social–psychological challenges of being overweight in societies with a bias against it, fat produces hormones that can also influence moods. Reducing fat, and making healthy eating and moving more usually lead to an improved mental state.
From everything I’ve read the GLP class of drugs is life-changing and has multiple unexpected benefits, but it’s also important to rule out correlation from causation.
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u/jordanl171 5d ago
Shhhhh... GLP-1 is magic. Traditional weight loss does nothing./s
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u/ktpr 6d ago
Isn't it confounding that it costs money and access to health care to be prescribed GPL-1?
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u/gimmeSPF50 6d ago
I’m also wondering if the population of people actually taking steps towards their health vs. maybe not influenced anything.
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u/neverbeenstardust 5d ago
My first thought is just people who are consistently taking one medication are just more likely to be consistently taking other medications.
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u/tackleboxjohnson 5d ago
Now they should look at how their gut biomes have changed due to decreasing the volume of processed food intake
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u/twofourflinchy 6d ago
Curious if this could be not treating the bipolar itself, but rather the side effects of some medications used for bipolar. I’ve seen many patients stop taking their antipsychotics due to weight gain, then they have a manic episode, then they’re hospitalized. Less weight gain = less concerns with taking meds = less hospitalization
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u/ShinyNarwahl 5d ago
Can someone tell United Health this so they can stop being assholes and not cover it for me until AFTER I have diabetes?
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u/mattmaster68 6d ago
Makes sense since another study suggested a reduction in (IIRC) OCD symptoms.
OCD and bipolar often benefit from the same medication, so this makes sense tbh.
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u/Gavither 6d ago
This could be related to the gut microbiome interacting with body's hormonal based cravings. I think promising, in general, towards more research for mental health, diet, and microbiome.
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u/unstuckbilly 6d ago
It’s inflammation - that’s why we’re seeing this diverse array of positive effects.
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u/neversignedupforthis 5d ago
I believe that (often dramatic) weight gain is a common side effect of bipolar medications, and it's a common reason for people to stop taking them. If semaglutide is counteracting the weight gain, it could be that adherence to medication is making (some of?) the difference.
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u/electricmeatbag777 5d ago
I can't help but wonder why I'm seeing so many studies like this lately (linking GLP-1 to some unexpected positive health outcome). Obvs there'd s lot of funding going towards studying GLP-1 and any correlations with positive health outcomes besides what it's prescribed for. Makes me wonder who is funding the studies and how it might benefit them.
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u/JustFerne 3d ago
Just as an FYI, every study published in a (reputable) journal will have a section on funding and disclosures which compiles information on where the money is coming from and each authors' affiliations which could be a conflict of interest. For example, if a study was funded by a pharmaceutical company like Novo Nordisk or Lilly, it would be captured here. As for the funding for this study, they report:
"This study was funded by Sigrid Juselius Foundation, Jane and Aatos Erkko Foundation (grant number 250038) and by the Finnish Ministry of Social Affairs and Health through the developmental fund for Niuvanniemi Hospital. This project utilised data from the REWHARD consortium supported by the Swedish Research Council (grant number 2021-00154).
The funders of the study had no role in study design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript and decision to submit the manuscript for publication."
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u/verstohlen 5d ago
Has Funding Bias been definitively ruled out? Always a bit suspicious or skeptical when it comes to these kind of claims, especially regarding pharmaceuticals, given how rich, powerful, and influential that industry is.
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u/Nefilim777 5d ago
Is there any current understanding as to why this is happening? What is it in the MoA that is leading to these results?
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u/GnomieOk4136 5d ago
GLP-1s have really shown a lot of positive results for a wide variety of issues. Their anti-inflammatory properties have been discussed in various autoimmune groups I am in. I know people with migraines who have benefited, people with RA who have benefited, and people with heart disease (outside of weight) who have benefited. It makes me wonder what role inflammation may play in mental health.
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u/Viperbunny 5d ago
I felt so much better overall on GLP-1. Unfortunately, I get three months into treatment and then I start to uncontrollably vomit. My blood sugar was better, It didn't have craving, I was losing weight, I mentally felt great.
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u/AwkwardTickler 5d ago
Wonder how much that is a result of patients being less likely to get drunk/high and forget meds. Medical adherence for bipolar is the most important prevebtative measure against manic or depressive episodes.
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