Liraglutide 3.0 mg and Mental Health: Can Psychiatric Symptoms Predict Adherence to Therapy? Insights from a clinical audit

Abstract

Introduction. The glucagon-like peptide-1 analogue liraglutide 3.0 mg is an out-of-pocket medication approved for weight management in obesity. We aimed to investigate the relationship between psychiatric symptoms (i.e., depression, anxiety, binge eating) and adherence to therapy. Methods. A clinical audit was carried out on 54 adults with obesity treated with liraglutide 3.0 mg. We retrospectively analyzed the relation between (1) psychiatric symptoms evaluated through the State-Trait Anxiety Inventory (STAI-Y1), the Beck Depression Inventory (BDI), the Binge Eating Scale (BES); and (2) adherence to therapy by assessing the maximum dosage (MD) and treatment duration (TD). Results. In the whole cohort, the average weight loss was 4.43% (± SD = 5.5). We found a negative correlation between anxiety symptoms (STAI-Y1 score) and MD (r=-,276), between depression symptoms (BDI score) and TD (r=-,276), and between a high probability of binge eating (BES score > 17) and TD (r=-,275). Linear regression analysis demonstrated that STAI-Y1 score predicted MD [R2 = .076, p = .044], BDI score predicted TD [R2 = .076, p = .044], and significant binge eating predicted TD [R2 = .076, p = .044]. Despite the lower adherence, the presence of psychiatric symptoms did not lead to a reduction in drug effectiveness on weight loss. Conclusion. Psychiatric symptoms can predict reduced adherence to liraglutide 3.0 mg therapy in real life. However, this does not appear to jeopardize its effect on weight loss. These findings suggest that persons with obesity and impaired mental health can also benefit from treatment. Level of evidence. Level V, descriptive studies.

Liraglutide-Induced Depression with Suicidality in an Obese Adult: A Case Report

“…Studies using an animal model suggest that liraglutide may exhibit anxiogenic effects and cognitive improvement but does not necessarily produce an antidepressant effect [10], while others have documented antidepressant effects [11], probably via improving hippocampal neural plasticity [12]. The literature suggests that liraglutide is safe for depression [13] and improves mood, cognitive function, and eating behaviour [14], and the anti-obesity properties are not affected by the presence of psychiatric symptoms [15]. A review and metaanalysis suggest that it significantly reduces depressive symptoms in diabetic patients [16].…”

Sex-Differences in Response to Treatment with Liraglutide 3.0 mg

“…The prescription of anti-obesity pharmacotherapy is not reimbursed by the Italian healthcare system, and the high cost represents one of the main barriers to treatment, as not all patients are able to afford it. In some real-world studies, patient payment for obesity medications has been identified as a cause of higher discontinuation rates [ 12 ]. In this study, during data collection, the patient’s visit date, prescribed dose, number of liraglutide prescriptions, any adverse effects, and whether these effects led to discontinuation of the medication were reviewed to determine whether the medication had been discontinued.…”

Liraglutide-associated depression in a patient with type 2 diabetes: A case report and discussion

“…[4] There were reports of increased suicidal ideation with the use of Liraglutide; however, a recent systematic review by the European Medicines Agency stated that there is no causal relationship between GLP-1RAs and suicide. [5] Further more, studies suggest potential antidepressant effects of GLP-1RAs, [6][7][8] which may be related to their involvement in the regulation of inflammation [9,10] and hormones such as cortisol and thyroid hormones. [11] Here, we report a case of a young male who developed depressive symptoms after using Liraglutide for blood sugar control and weight reduction.…”