Add Cognition and Addiction to the List of Things Ozempic Might Improve

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Key Takeaways

• A new study found that semaglutide did not increase the risk of neurological outcomes for patients.

• While the study did not examine causes, one possible theory about why semaglutide did not increase the risk of neurological outcomes is that it has anti-inflammatory benefits, which may help prevent cognitive decline.

• Scientists are interested in its potential, but semaglutide is currently not approved by the Food and Drug Administration (FDA) for cognitive disorders or substance use disorders.
  

Semaglutide, marketed under Ozempic, Rybelsus, and Wegovy, depending on its formulation and use, is mainly a treatment for type 2 diabetes. However, the benefits of the drug extend beyond treating the condition.

Not only has semaglutide been making headlines as an effective treatment for obesity, but research has also indicated it could help reduce the risk of heart attack and improve sleep apnea.

A recent study examining whether semaglutide could raise the risk of neurological conditions provided reassuring evidence to the contrary. Now, researchers are wondering if the drug could have cognitive benefits.

Related: Hims & Hers Is Now Selling Semaglutide: Here's What You Should Know

Does Semaglutide Affect the Brain?

Riccardo De Giorgi, MD, DPhil, a clinical lecturer at the University of Oxford Department of Psychiatry and the study’s primary author, told Verywell that some regulatory agencies, such as the European Medicines Agency (EMA), have raised concerns about possible negative mood and suicidal ideation linked to semaglutide. The concerns prompted a review, which was initiated in July 2023.

However, a recent National Institutes of Health-funded study published in January 2024 found that people taking semaglutide had a 49% to 73% lower risk of suicidal ideation than people taking other medications.

Since the data hasn’t created a clear picture, Giorgi and his research team set out to conduct a study that would gauge patients’ risk for developing 22 neurological conditions within a year of starting semaglutide.

The conditions the researchers were looking for included: 

• Encephalitis

• Parkinson’s disease

• Cognitive deficits

• Dementia

• Epilepsy/seizure

• Migraine

• Insomnia

• Nerve disorders

• Myoneural junction/muscle disease

• Intracranial hemorrhage

• Ischemic stroke

• Substance use disorders (e.g., alcohol, opioids, cannabis, stimulants, and nicotine)

• Psychosis

• Bipolar disorder

• Depression

• Anxiety

• Obsessive-compulsive disorder

• Suicidality

The study analyzed data from the TriNetX U.S. Collaborative Network, which contains anonymized electronic health records from over 100 million patients. The researchers filtered data by age, condition, treatment, and time frame for their analysis. It’s important to note, however, that the study did not specify which dosage or brand of semaglutide participants used.

The researchers found that semaglutide did not appear to increase the risk of poor neurological outcomes for patients taking the medication. Specifically, the study noted that taking “semaglutide was not associated with any increased risk of a first diagnosis of neurological or psychiatric condition.”

In fact, semaglutide was associated with a significantly lower risk of cognitive deficits compared to diabetes medications sitagliptin and glipizide. People taking semaglutide also showed a lower risk of dementia and nicotine misuse compared to those taking the other medications.

However, Giorgi emphasized that causality cannot be determined by doing this type of study. It does leave researchers with some interesting questions, though. Some studies have suggested that semaglutide can reduce inflammation—something we know can benefit the whole body, including the brain.

For example, a 2019 study found that diets influence cognitive aging through inflammatory pathways. Another study showed that the antioxidant and anti-inflammatory compounds found in certain foods reduced cognitive decline in Alzheimer’s disease.

In theory, if drugs like semaglutide might be able to help with inflammation, researchers wonder if that means it could have brain health benefits, too.

Related: How Wegovy Helps You Lose Weight

Off-Label Semaglutide for Cognitive Enhancement or Addiction Treatment

Study author Ivan Koychev, PhD, a clinical academic psychiatrist at the University of Oxford Department of Psychiatry, told Verywell that while he’s not an expert on off-label prescriptions, he thinks that unapproved use of semaglutide would be uncommon.

“It would be unusual for people to prescribe it for that purpose in the absence of very good evidence that it works, and at the moment, it’s largely indirect,” said Koychev, adding that he thinks “most people would be quite cautious about prescribing it off-label in the United Kingdom.”

In the U.S., the FDA has approved Ozempic injections and Rybelsus tablets to lower blood sugar levels in adults with type 2 diabetes. Wegovy injections have been approved to help reduce excess body weight and to reduce the risks of cardiovascular events such as heart attack or stroke. Semaglutide is not FDA-approved for other uses, like treating cognitive deficits or nicotine addiction.

The bottom line? Koychev said that “medications such as semaglutide may be powerful tools for a range of health conditions, but they are novel drugs and need much more investigating.”

What This Means For You

In the U.S., semaglutide is only approved to treat type 2 diabetes and obesity and help lower cardiovascular risk. However, more research is needed to determine whether semaglutide would be beneficial for cognition and addiction.

Read the original article on Verywell Health.