It can help weight loss and ward off disease, but can Ozempic fight depression?
By Rachel McDonald, the Australian Science Media Centre
For people with major depressive disorder, just getting out of bed to do the things that could make you feel better can seem impossible. However, international researchers have found that people with major depression taking a semaglutide pill - the oral form of Ozempic or Wegovy - could be seeing an improvement in motivation.
The researchers conducted a small study with 72 people who were overweight and had a major depressive disorder diagnosis, randomising half to receive the semaglutide pill and half to receive a placebo over 16 weeks. In a secondary analysis, they found that those who received the semaglutide pill showed an increased willingness to exert physical effort, and perceived the cost of effort relative to reward to be lower.
Dr Atheeshaan Arumuham from the Kings College London Institute of Psychiatry, Psychology & Neuroscience told the UK SMC that the change in motivation was picked up through a laboratory-based task to measure a person's willingness to exert effort for reward.
"This task involves choosing on each trial between an easy option with a small, guaranteed reward and a harder option that requires more effort but offers a larger reward with a stated probability. This allowed researchers to see how willing someone is to expend effort when the payoff is higher," Dr Arumuham said.
"In previous studies using this task, patients with depression have been found to have less motivation to spend effort for higher rewards, while also being less able to weigh up the information of the size and chance of getting the rewards."
The study authors say research on glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as semaglutide, consistently indicates that the drugs are having an impact on the brain's reward system.
Neurophysiologist Dr Francesco Tamagnini from the University of Reading said many researchers were investigating how GLP-1 RAs can impact motivation and mood.
"Their therapeutic use in weight management and type 2 diabetes extends beyond effects on glucose metabolism, as these agents also appear to influence motivational processes," Dr Tamagnini said.
Professor Stella Chan, also from the University of Reading, said the findings were encouraging as a reduced sense of enjoyment was "one of the core symptoms of clinical depression".
"However, readers should be aware that these findings were based on a relatively small sample of depressed patients with Body Mass Index (BMI) over 25 and hence they should be treated with caution until more research on a wider range of patient populations is conducted,” Dr Chan said.
Dr Arumuham said as the research was a secondary analysis, the study was not originally set up to fully investigate the role semaglutide can play in managing symptoms of depression, and the result "does not mean semaglutide is an antidepressant."
"The results speak to one specific process linked to depression, not to treatment of the disorder itself," he said.
He said healthcare practitioners should not change their advice based on research like this, but the study opened up promising new areas of research for more direct investigation of GLP-1 RAs and mental health care.
Dr Tamagnini said there could also be more to discover about why a drug aimed at managing blood sugar could have this impact on the brain.
"While the findings suggest that semaglutide may have potential as a treatment for major depressive disorder, they also open the way for broader investigations into the functional overlap between glucose metabolism and the regulation of mental functions, including motivation,” he said.
You can find out more about the paper here
You can read the full UK Expert Reaction here
This article originally appeared in Science Deadline, a weekly newsletter from the AusSMC. You are free to republish this story, in full, with appropriate credit.
Contact: Rachel McDonald
Phone: +61 8 7120 8666
Email: info@smc.org.au