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Abstract
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In recent months, there has been a lot of talk about the use of glucagon-like peptide 1 (GLP-1) receptor agonists, not only in type 2 diabetes but also for its effects on weight loss. Because of its wide use for this purpose and recent reports of suicidal thoughts and self-injury in patients taking liraglutide and semaglutide, GLP-1 receptor agonists have also come under the scrutiny of the European Medicines Agency (EMA), which has launched an investigation into these new adverse events.
There is a wealth of research on brain changes in major depressive disorder (MDD) and suicidal ideation and behaviour. Previous research has highlighted changes in resting state functional connectivity (RSFC) in brain regions thought to be critical for emotion regulation and impulsivity, such as the amygdala, orbitofrontal cortex and anterior cingulate cortex.1, 2 A recent review of neuroimaging evidence for suicidal thoughts and behaviours in MDD highlighted the importance of prefrontal cortices and their interplay with the limbic system.3 Research on resting state networks has also focused on the aforementioned regions, with particular attention to changes in and between default mode, salience and frontoparietal networks in patients with suicidal ideation and attempts.4 Patients with MDD with suicidal ideation and/or behaviour show declines in RSCF in mentioned areas compared with patients with MMD without suicidal ideation and/or behaviours.2-4
Given recent reports of adverse effects and interest in GLP-1 receptor agonists, we compared RSFC in brain regions identified in previous studies as important for suicidal ideation and behaviour in a 16-week, placebo-controlled study comparing the semaglutide intervention group with the placebo group. The goal of this study was to evaluate if there is any indication that semaglutide intervention could have an effect on RSFC that would reflect the change observed in suicidal ideation/behaviour.
Language: en |