GLP-1 Receptor Agonists and Related Mental Health Issues; Insights from a Range of Social Media Platforms Using a Mixed-Methods Approach

Davide Arillotta; Giuseppe Floresta; Amira Guirguis; John Martin Corkery; Valeria Catalani; Giovanni Martinotti; Stefano L Sensi; Fabrizio Schifano

doi:10.3390/brainsci13111503

GLP-1 Receptor Agonists and Related Mental Health Issues; Insights from a Range of Social Media Platforms Using a Mixed-Methods Approach

Brain Sci. 2023 Oct 24;13(11):1503. doi: 10.3390/brainsci13111503.

Authors

Davide Arillotta^{1

2}, Giuseppe Floresta^{2

3}, Amira Guirguis^{2

4}, John Martin Corkery², Valeria Catalani², Giovanni Martinotti^{2

5}, Stefano L Sensi^{5

6}, Fabrizio Schifano²

Affiliations

¹ School of Clinical Pharmacology and Toxicology, University of Florence, 50121 Florence, Italy.
² Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK.
³ Department of Drug and Health Sciences, University of Catania, 95124 Catania, Italy.
⁴ Pharmacy, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea SA2 8PP, UK.
⁵ Department of Neurosciences, Imaging and Clinical Sciences, University of Chieti-Pescara, 66100 Chieti, Italy.
⁶ Center for Advanced Studies and Technology (CAST), Institute of Advanced Biomedical Technology (ITAB), University of Chieti-Pescara, Via dei Vestini 21, 66100 Chieti, Italy.

Abstract

The emergence of glucagon-like peptide-1 receptor agonists (GLP-1 RAs; semaglutide and others) now promises effective, non-invasive treatment of obesity for individuals with and without diabetes. Social media platforms' users started promoting semaglutide/Ozempic as a weight-loss treatment, and the associated increase in demand has contributed to an ongoing worldwide shortage of the drug associated with levels of non-prescribed semaglutide intake. Furthermore, recent reports emphasized some GLP-1 RA-associated risks of triggering depression and suicidal thoughts. Consistent with the above, we aimed to assess the possible impact of GLP-1 RAs on mental health as being perceived and discussed in popular open platforms with the help of a mixed-methods approach. Reddit posts yielded 12,136 comments, YouTube videos 14,515, and TikTok videos 17,059, respectively. Out of these posts/entries, most represented matches related to sleep-related issues, including insomnia (n = 620 matches); anxiety (n = 353); depression (n = 204); and mental health issues in general (n = 165). After the initiation of GLP-1 RAs, losing weight was associated with either a marked improvement or, in some cases, a deterioration, in mood; increase/decrease in anxiety/insomnia; and better control of a range of addictive behaviors. The challenges of accessing these medications were a hot topic as well. To the best of our knowledge, this is the first study documenting if and how GLP-1 RAs are perceived as affecting mood, mental health, and behaviors. Establishing a clear cause-and-effect link between metabolic diseases, depression and medications is difficult because of their possible reciprocal relationship, shared underlying mechanisms and individual differences. Further research is needed to better understand the safety profile of these molecules and their putative impact on behavioral and non-behavioral addictions.

Keywords: GLP-1 receptor agonists; anxiety; depression; food cravings; mental health; netnography; semaglutide; sleep disorders; social media.

Grants and funding

The study was carried out with the internal support of the University of Hertfordshire (GL11101336—Centre Clinical and Health Services QR).