Fewer Suicidal Thoughts in Teens Getting a GLP-1

Women and ChildrenAdolescence is hard. With respect to mental health, especially of late, the environment is especially harsh. Even harsher if an adolescent is living with obesity. So a recent study in JAMA Pediatrics showing teens with obesity are having fewer suicidal thoughts when they get a GLP-1 is welcome news. Authors Liya Kerem and Joshua Stokar sum up their findings:

“This large multicenter cohort study found that prescription of GLP1R (Glucagon-like peptide 1 receptor agonists) in adolescents with obesity was associated with decreased risk for suicidal ideation. Future prospective studies should assess the association of GLP1R treatment with psychiatric outcomes in adolescents with obesity.”

Observational of Course

Certainly this is good news, though it is not evidence that taking a GLP-1 actually protects teens from suicidal thoughts if they have obesity. We would need a carefully designed RCT for that. This is an observational study offering insight into correlation, not causation. Aaron Kelly is co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota. He explains:

“This new study provides additional reassurance, beyond observations in the clinical trials, that the GLP-1 receptor agonists do not increase suicidal thoughts or attempts in adolescents with obesity. The findings of this study suggesting a reduced risk will need to be confirmed in future research. This includes trying to identify the mechanisms responsible for the improvements.”

Better Than Anecdotes

To be sure, we want to see more research. If getting treatment for obesity indeed has the potential for improved mental health outcomes, we need to know it. We also need to know where the risks are, because obesity and mental health can interact in complex and sometimes surprising ways.

However, these findings are valuable because they provide perspective on anecdotal reports of suicidal ideation in patients taking these drugs. Such reports created a stir last year and led to investigations by the U.S. FDA and the EMA. Both of those investigations concluded there was no evidence for a causal link. But earlier this year, a study in JAMA Open Networks found a “signal” of suicidal thoughts associated with semaglutide. The authors called for “urgent clarification.”

In light of all the available evidence, we have some assurance that these drugs are not causing a big problem with suicidal thoughts. But we also know that mental health evaluations are essential for persons receiving care for obesity, and especially for adolescents. More knowledge is better and vigilance is key.

Click here for the study in JAMA Pediatrics, here, here, and here for further reporting on it. For perspective on related data in adults, click here and here.

Women and Children, painting by Auguste Herbin / WikiArt

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October 22, 2024

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