The safety of semaglutide in patients with depression and obesity

TO THE EDITOR: The bidirectional relationship between obesity and depression is complex, with each condition potentially exacerbating the other and increasing their respective pathogenic risks [(1)]. The treatment of patients with obesity and depression is particularly challenging due to the unique characteristics of this patient population. Semaglutide, an emerging treatment option, has shown significant potential in weight management and blood glucose control [(2)]. Therefore, evaluating its safety in patients with depression is crucial. The safety of semaglutide has been a topic of significant debate in recent literature for patients with both depression and obesity. The case study by Li et al. reported depressive symptoms following the use of semaglutide in patients without a history of depression, suggesting that the drug may trigger depressive episodes in susceptible individuals [(3)]. This finding has raised concerns regarding its clinical use. However, based on my clinical experience and a comprehensive review of existing literature, I remain confident in the safe use of semaglutide in patients with comorbid depression and obesity. The study by Kushner et al. confirmed the weight loss effects of semaglutide in adults with overweight and obesity, noting that its adverse event profile remained consistent regardless of antidepressant use [(1)]. Additionally, Furlan et al. supported the potential of glucagon-like peptide-1 (GLP-1) therapy in weight management for psychiatric patients. Notably, GLP-1 is not metabolized through cytochrome P450 in the liver, thereby reducing the risk of drug interactions [(4)]. The study by Chen et al. suggested potential antidepressant effects of GLP-1 receptor agonists, although the exact mechanism remains unclear [(5)]. Other reports have also reached similar conclusions, with some speculating that GLP-1 receptor agonists may help alleviate depressive symptoms. By reducing weight and improving metabolic parameters, semaglutide can enhance the quality of life for patients and mitigate the weight gain associated with psychotropic drugs. Existing evidence suggests that semaglutide is safe and effective for patients with obesity, including those who are on antidepressants [(1)]. However, clinicians should remain vigilant and monitor for potential psychological side effects, especially in patients with a history of depression or new psychiatric symptoms. Given the efficacy of semaglutide in correcting metabolic disorders and promoting weight loss, continued research is essential, particularly focusing on its long-term safety and efficacy. The authors declared no conflict of interest.