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Cognitive problems are common in psychotic and mood disorders, affecting memory, attention, and everyday functioning, yet effective treatments remain limited.
The study, published in BMJ Mental Health, analysed electronic health records from 13,007 adults in the USA with a psychiatric diagnosis. Researchers compared cognitive symptoms over the 12 months following initiation of semaglutide with those associated with other antidiabetic treatments.
Semaglutide was associated with 17% to 19% fewer cognitive symptoms than two other commonly used diabetes drugs, and 25% fewer than no antidiabetic treatment; cognitive symptoms were similar to those seen with sitagliptin. Associations were strongest for memory problems and broader cognitive functions, and were most consistently observed in people with major depressive disorder.
Dr Riccardo De Giorgi, Senior Clinical Researcher at the Department of Psychiatry, University of Oxford, and lead author, said:
“Cognitive problems are among the most difficult aspects of mental illness to treat, and they can have a profound impact on people’s everyday lives. What I find particularly interesting here is that the association was strongest for memory and broader cognitive functions, and was most consistent in people with depression. The similarity between semaglutide and sitagliptin is also intriguing. The two drugs act differently but both involve the GLP-1 system, raising the possibility that this pathway, perhaps together with improvements in metabolic health, could help explain the cognitive effects we observed”.
The researchers used NeuroBlu, a large database of de-identified electronic health records from US mental healthcare organisations, and accounted for changes in treatment and other clinical factors over time.
Dr Maxime Taquet, Associate Professor at the Department of Psychiatry, University of Oxford, who supervised the study, said:
“The results are particularly exciting because many people with psychiatric conditions also have diabetes. Our findings suggest that both diabetes and cognitive problems might be treated with the same drug. There is virtually no treatment for cognitive problems in people with severe mental illness, and our study might point to a first potential treatment. Our study is observational and will therefore need to be confirmed with a clinical trial.”
The researchers caution that the findings apply to people prescribed antidiabetic medication in routine care and may not extend to younger people, those without diabetes, or people receiving semaglutide primarily for weight management.