Liraglutide 3.0 mg and mental health: can psychiatric symptoms be associated to adherence to therapy? Insights from a clinical audit

Abstract

Introduction Liraglutide 3.0 mg, a glucagon-like peptide-1 (GLP-1) analogue, is a medication approved for obesity treatment. This study aimed to investigate the relationship between psychiatric symptoms, including depression, anxiety, and binge eating, and their impact on therapy adherence. Methods A clinical audit was carried out on a cohort of 54 adults with obesity treated with liraglutide 3.0 mg. We retrospectively analyzed the connection between psychiatric symptoms assessed through the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and Binge Eating Scale (BES). Adherence to therapy was assessed by the maximum dosage (MD) and treatment duration (TD). Results Notably, a discontinuation rate of 59% was encountered. However, among those who continued the treatment, we observed a negative association between anxiety symptoms (STAI score) and MD, depression symptoms (BDI score) and TD, and a higher likelihood of binge eating (BES score > 17) and TD. Moreover, presence of psychiatric symptoms did not compromise drug's effectiveness in achieving weight loss, which was 4.43% (± 5.5 SD) in the whole sample and 5.3% (± 6.3 SD) in the subgroup evaluated at 12 weeks. Conclusion We observed a high discontinuation rate in real-life clinical setting, where Liraglutide 3.0 therapy is paid out-of-pocket. While psychiatric symptoms might play a role in diminishing adherence to therapy, they do not prevent drug's effectiveness to promote weight loss. This finding underscores the potential advantages of liraglutide 3.0 mg therapy for individuals contending with obesity while simultaneously managing mental health challenges. Level of evidence Level V, descriptive studies.

Gender-Difference 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, and number of liraglutide prescriptions were reviewed to determine whether the medication had been discontinued.…”

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 – 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.…”