Cognitive signs and symptoms in people with a psychiatric diagnosis on semaglutide: a retrospective cohort study of 13 007 patients in the USA
Abstract
Abstract Background Cognitive deficits across psychiatric disorders are common and difficult to treat. Semaglutide, a GLP-1 receptor agonist, shows potential cognitive benefits in diabetes and obesity, but effects in psychiatric populations remain unclear. Objective To determine whether initiation of semaglutide is associated with fewer cognitive signs/symptoms over 12 months among adults with psychiatric disorders. Methods Retrospective cohort study using de-identified multicentre US electronic health records (EHRs) in NeuroBlu Data spanning 1999–2024. We included adults with any International Classification of Diseases (ICD)-9/-10 psychiatric diagnosis with at least one semistructured, clinician-rated routine cognitive assessment in the 12 months before and at least one in the 12 months after initiating an antidiabetic drug. Semaglutide initiation was compared against four comparator strategies including sitagliptin, empagliflozin, glipizide or no antidiabetic treatment. Primary outcome was a 0–100 composite cognitive score (0, no signs/symptoms recorded; 100, signs/symptoms present across all domains) derived from semistructured, clinician-rated routine cognitive assessments across memory, attention, orientation and other cognitive functions, with a 12-month follow-up after antidiabetic drug initiation. We estimated mean ratios (MR) and 95% CIs between comparisons with the parametric g-formula, adjusting for baseline cognitive score and prespecified covariates. Additional…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 13 participants or records.
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