Though it is early days, some medical practitioners working in the field of psychiatry are “cautiously optimistic” that weight loss drugs such as Ozempic could have benefits for those suffering from various mental health disorders.
Experts in the field who spoke to Newsweek explained there was a link between obesity and certain psychological conditions which the drugs may be able to help alleviate—though they said it was too soon to tell what effects on mental health semaglutide, which is sold under various brand names, including Ozempic, across the globe, could have, whether positive or negative.
“It’s a significantly understudied area of science, and our populations and individuals with mental health [conditions] in general stand to benefit a lot from understanding the effects of these medications,” Dr. Mahavir Agarwal, an assistant professor in psychiatry at the University of Toronto and a scientist at the Centre for Addiction and Mental Health (CAMH), told Newsweek.
It comes amid reports that some psychiatrists have been prescribing Ozempic to patients on antipsychotics and antidepressants to lessen the weight-gain side effects that are known to happen in some cases.
A series of magnetic resonance imaging (MRI) scans of a human brain. Researchers are using the scans to try to see if weight loss drugs improve cognition in mental health patients. Getty Images
Dr. John Buse, a medical professor and director of the University of North Carolina’s Diabetes Care Center, who has worked on clinical trials of semaglutide for several decades, told Newsweek he had received a call from a patient in the past two weeks asking about just such a request.
“[With] antipsychotics, people can have 10, 20, 30, 50 percent body weight gain,” he said. “I think that’s what the crux of the matter is; I don’t think anybody really thinks this is a first-line therapy for depression, anxiety, thought disorders.”
Agarwal said that people with mental conditions were more exposed to weight gain and associated physiological problems as “there is inherent biological overlap; sometimes lifestyle factors are problematic or difficult to persist; there are system challenges—our systems could work better—but our treatments are also part of the problem.”
“I’m not saying people should not be on anti-psychotics or antidepressants when they need them,” he said. “I’m just saying they have side effects, and weight gain is a major side effect. And if they could have a medication strategy that could take away that side effect, leaving the mental health benefits, that’s a good idea.”
As such, weight loss drugs could very well help improve a patient’s body image, making them potentially less likely to stop taking other medications that may be contributing to it.
But while its ability to reduce obesity and associated comorbidities has been demonstrated with a recently published major trial—in which Ozempic producer Novo Nordisk compared semaglutide to a placebo among 17,604 adults over the age of 45, and found it helps people lose an average of 15 percent of their weight and reduces the prevalence adverse cardiovascular events by 20 percent—questions remain about its potential side effects, both good and bad.
Psychiatrists say more research needs to be done to understand the full extent of what effects on the brain semaglutide has, but that there were early indications it and other medications like it may help with certain mental disorders.
Jamie Bennett, a spokesperson for Novo Nordisk, which produces semaglutide products including Ozempic, said the company “is continuously performing surveillance of the data from ongoing clinical trials and real-world use of its products and collaborates closely with the authorities to ensure patient safety and adequate information to healthcare professionals.”
She added that the Food and Drug Administration requires weight management drugs that work on the nervous system to “carry a warning about suicidal behavior and ideation,” but that this “had been reported in clinical trials with other weight management products.”
Dr. Margaret Hahn, also a professor of psychiatry at the University of Toronto and a clinician at CAMH, told Newsweek that there had been more research done on metformin, a diabetes drug that also reduces appetite, and mood conditions such as depression and bipolar disorder, which had given “very nice preliminary data” to suggest that regulating metabolic abnormalities improved brain functions and reduced depression.
She and Agarwal are collating a study, which is still in progress and for which results have yet to be published, on whether semaglutide could improve weight and metabolism among schizophrenic patients who were obese and for whom metformin was not effective for weight loss—but is also using MRI scans to track changes in cognition.
Boxed of the diabetes and weight loss drug Ozempic rest on a pharmacy counter on April 17, 2023, in Los Angeles, California. Medical professionals are getting to grips with the possible side effects of the medication as its usage rapidly increases. Mario Tama/Getty Images
“If we see these effects with metformin, potentially with some of these more powerful weight loss and anti-diabetes medications, we may glean even better benefits,” Hahn said. “It’s too early to say, but we’re cautiously optimistic.”
She added: “Right now, the data’s quite limited in terms of whether these medications have benefits on mental health.” Hahn noted there were six randomized controlled trials looking at schizophrenia and the class of drug, of which theirs was one, “but they haven’t been focusing on mental health benefits and weren’t powered or weren’t designed to do so.”
Agarwal said that in the “limited clinical experience” they have had to test the drugs so far, they had not seen many mental side effects, but signs that semaglutide “might help a variety of mental health conditions.”
Why Some Patients Can’t Use Ozempic
However, there are physiological side effects to the drugs that can be experienced by some that may inhibit patients from using them. Buse said at the start of one of his semaglutide clinical trials, patients were excited about slimming down but felt “a little wrung out from losing that much weight that fast.”
Other common side effects of the drug can include nausea and vomiting, though Hahn said: “What we find in general is, for most, these effects are transient and go away with time—and ironically, actually, anti-psychotic medications are used as anti-nausea medications in lower doses in cancer [treatment], so that can actually be a protective factor.”
The attraction of Ozempic for those who are overweight and struggling with mental health conditions may be more simplistic, though. Buse said long-term studies suggested there was “some modest improvement in quality of life” for both weight loss and diabetes patients prescribed the drug.
“I get the sense that some people feel much more energetic after they’ve lost a substantial amount of weight; other people I think just feel good about having overcome this health issue for themselves,” he said.
Note: The UNC School of Medicine has received funding to provide consultation services to Novo Nordisk, among other pharmaceutical companies. This work has contributed a small percentage to Buse’s salary but has not changed or increased his salary.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
