While many people know about Ozempic and Wegovy, they may not know the difference about the possible mental health effects of each drug.
The Wegovy label mentions anxiety, depression, and suicidality as adverse effects but the Ozempic label does not.
“Mental health issues are side effects that should not be ignored or minimized. The consumer should always maintain the right to know the consequences as well as the benefits of using any drug or product,” Dr. Raafat Girgis, psychiatrist and clinical director of Moment of Clarity, told Healthline.
However, there is a valid reason that Ozempic does not include these mental health effects on its label, said Dr. Sethu Reddy, president of the American Association of Clinical Endocrinology.
“It’s not that the FDA or (drug companies) are lying to the public or hiding things,” he told Healthline.
He explained that when drug companies conduct clinical trials to obtain FDA approval, they must collect and report all adverse events that occur more often in patients who receive the drug than in those who do not. in the placebo group.
Once the drugs are approved by the FDA and available to the public, doctors are required to continue reporting the adverse effects they witness to patients to the FDA Adverse Event Reporting System (FAERS).
“You can get some of these bad side effects if something is used in a million patients. While 1 or 2 out of a million people will have a side effect, it doesn’t appear in the original studies for FDA approval, which were conducted on a much smaller number of patients,” said Reddy. “This does not mean that the industry is hiding the side effects from the public; it is simply the nature of how to collect the data.”
As adverse effects are documented once drugs are used more widely, research is often prompted and side effects are sometimes added to the label.
The active ingredient in Ozempic and Wegovy is semaglutide, which is a glucagon-like peptide-1 (GLP-1) receptor agonist.
Semaglutide mimics the GLP-1 hormone released in the gastrointestinal tract in response to food. GLP-1 prompts the body to produce more insulin, which lowers blood sugar. That is why Ozempic is prescribed for diabetes.
In addition, GLP-1s in higher amounts also interact with parts of the brain that reduce appetite and signal a feeling of fullness. Like thisthe active ingredient in Wegovy helps people lose weight.
The higher amount of semaglutide in Wegovy compared to Ozempic may be why mental health effects were seen more frequently in clinical trials for Wegovy and not for Ozempic, Reddy said.
“When (medications) try to suppress your appetite, a lot of other things happen in the brain as well, from depression to anxiety,” he said. “Maybe you’ll see less of the side effects of GLP-1 like semaglutide, but even so, with drugs that have an effect on the brain, you always have to watch for any central nervous system effects.”
He noted that the psychological and mental state of patients taking Wegovy for weight loss compared to patients taking Ozempic for diabetes management may also be a factor in mental health.
“Mental health is obviously very important for weight management because if you think about all the mental health factors that feed people – stress from bad or happy things tend to trigger those people who eat, anxiety is a big part of it, social attitudes towards weight. gain, coping mechanisms for emotional and physical abuse,” said Reddy.
Girgis added that the common side effects of Ozempic and Wegovy, such as nausea, vomiting, constipation, and diarrhea can trigger mental health side effects.
“I think the worst effect is the gastrointestinal effect of the injection. If the body is not able to release waste in a normal way, it rejects the reaction and tries to regulate itself, causing confusion in your natural state of motion. The mental aspect of anxiety and worry can be exacerbated by how your body reacts to the procedure,” Girgis said.
Dehydration due to gastrointestinal side effects can also affect mental health, he said.
The type of hormone, the purpose it is used for, and a person’s gender all factor into whether hormones can cause mental health effects.
For example, Reddy says that insulin is a hormone that, when taken in appropriate amounts, does not cause changes in mental health.
Other hormones such as testosterone and estrogen are circumstantial.
For example, Girgis said testosterone can cause a number of mental health issues, such as anger, restlessness, and an aggressive response.
However, Reddy says that when given to men with low testosterone, it can improve their outlook on life, energy, and exercise tolerance.
When a woman goes through menopause and has mental health changes, sometimes depression and anxiety develop when she takes oral estrogen, Reddy said.
Girgis said, “it is important to know and understand that depression, mood swings, anxiety, and sadness can occur at any time in any gender when injectable hormones are placed in the body.”
If you feel that your mental health has changed while taking a GLP-1 such as Ozempic or Wegovy, contact your doctor immediately.
“If they can’t be reached, go to the emergency room or urgent care,” says Girgis.
You can rest assured that there are alternative medicines and treatment options for diabetes and weight gain. Often, doctors will initially reduce the dosage to see if it helps alleviate the mental health effects.
“Any drug has what we call a therapeutic window, so if you take too much aspirin, it can cause a gastric ulcer or bleeding, etc. not cause side effects,” said Reddy.
After a trial and error, they may stop the medication for a few weeks to see if the mental health improves and then you restart the medication.
“If the feelings change again, then you have your answer and we usually try a lower dose or try a different drug,” said Reddy.
The fact that Ozempic’s label does not mention anxiety, depression, or suicidality on its label even though Wegovy’s label does is because Wegovy has higher levels of semaglutide.
This difference may prompt further research on the subject.
If you think you are experiencing mental health effects while taking Ozempic, Wegovy or other GLP-1, contact your doctor immediately.