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Tuesday, December 19, 2023

After Weight Loss, Ozempic Is Set to Conquer a Universe of Mind Problems

One inescapable phrase dominated biomedicine this yr: Ozempic.

Physicians have been amazed on the drug’s efficacy in treating diabetes, for which it’s FDA accepted, and weight problems. Social media propelled it into the yr’s zeitgeist as a “miracle” weight-loss drug that may assist individuals effortlessly shed kilos—for well being or for vainness.

It’s no marvel. Fat burners have an extended and tumultuous historical past. From amphetamine-laden “rainbow drugs” to the infamous fen-phen and its lethal uncomfortable side effects within the lungs and coronary heart, these drugs have a killer popularity.

Scientists have lengthy looked for a secure and efficient capsule that curbs urge for food with out harmful penalties. Although it isn’t freed from uncomfortable side effects, Ozempic comes a lot nearer to becoming the invoice. It really works its magic by mimicking the physique’s pure response after a satisfying meal—it makes the consumer really feel full. With out having to withstand fixed starvation, the kilos soften away.

For many individuals scuffling with weight problems, the drug is a possible lifesaver. Extra weight is related to greater incidences of stroke, coronary heart and liver illness, sleep apnea, joint issues, and a few cancers. A serious medical trial this yr in tens of hundreds of chubby individuals with out diabetes discovered the primary ingredient in Ozempic, semaglutide, lowered the danger of stroke and coronary heart assault, whereas reducing the probabilities of dying resulting from cardiovascular issues.

Maybe much more importantly, the drug is steadily altering societal views on weight problems—it’s not resulting from lack of will energy, however a continual medical situation that may be handled.

However Ozempic and related medication—like Wegovy, one other semaglutide-based treatment that has been FDA-approved for weight reduction—are already set for the subsequent chapter: tackling a variety of mind issues, together with Alzheimer’s and Parkinson’s. Medical trials are underway for dependancy, and the medication are displaying early promise battling bipolar dysfunction and despair.

Intestine to Mind

Why would medication helpful within the remedy of diabetes and weight reduction additionally show efficient for temper, dependancy, and neurodegenerative illnesses?

It comes right down to how Ozempic and Wegovy work. Each comprise semaglutide, a chemical that mimics a hormone referred to as glucagon-like peptide-1, or GLP-1. After a meal, as our intestine senses an inflow of vitamins, cells within the gut launch the hormone. GLP-1 tells the abdomen to decelerate how briskly it’s emptying its contents. It additionally triggers the pancreas to launch extra insulin to maintain blood sugar in test—sustaining a metabolic state that’s essential for mind well being.

However right here’s the crux. GLP-1 doesn’t simply roam the intestine; it additionally simply enters the mind.

Protected by a tight-knit mobile barrier, the mind typically rejects giant molecules that might harm its delicate neurons, however it readily admits GLP-1. The hormone prompts neurons in a variety of mind areas, together with the “reward heart” and hippocampus, which play essential roles within the regulation of temper and reminiscence.

This has neuroscientists questioning: Can GLP-1 tweak mind perform to assist neurological or psychological well being?


One tantalizing aspect impact of individuals taking GLP-1-like medication has been that they’re much less taken with consuming alcohol and different mind-bending substances. Why this occurs is unclear, however it’s doubtless as a result of the hormone dampens reward pathways within the mind.

One research, for instance, gave alcoholic monkeys (yup, that’s a factor) entry to an open bar for 4 hours a day. These monkeys love their booze. Thriving within the Caribbean, they’re infamous for swiping alcoholic drinks from vacationers. After two to 5 weeks of remedy, these injected with GLP-1-like medication lowered their alcohol consumption even when tempted with all-you-can-drink alcohol. As an alternative, they readily slurped contemporary water.

GLP-1 mimics can also assist curb smoking dependancy. A small medical trial in 2021 discovered people who smoke, whereas sporting nicotine patches, readily kicked the behavior when injected with a first-generation GLP-1 drug. Practically half of the GLP-1 handled contributors give up smoking—successful price nearly double that of a management group that solely wore nicotine patches.

As with all new drug, the outcomes aren’t minimize and dried. One research for alcoholism utilizing a first-generation GLP-1 mimic discovered little distinction in individuals present process behavioral remedy. Each teams lowered their alcohol consumption, however the GLP-1 drug didn’t additional bolster restoration. A trial utilizing the drug for cocaine abuse additionally discovered negligible results.

That mentioned, semaglutide is way extra environment friendly than first-generation GLP-1 mimics. Medical trials are within the works, some utilizing brain-imaging to see how the mind reacts to the drug in actual time.

Temper Problems

Despair and different temper issues are additionally potential targets for GLP-1 mimics.

Typically thought-about purely neurological, temper is tightly linked to different components of the physique, together with the intestine. Individuals with despair typically expertise modifications in urge for food and intestine hormone ranges—together with GLP-1.

An evaluation of six trials with over 2,000 contributors discovered GLP-1 mimicking medication eased their despair. One other trial involving 29 individuals with bipolar dysfunction or despair discovered the medication leveled temper swings for at the very least six months after remedy.

The medication may work by altering neural connections within the mind.

Neurons look a bit like timber, with big trunks that course of data and branches that “discuss” to neighbors. These branches wither in a depressed mind, making it troublesome for neurons to attach to one another and type wholesome networks. What’s extra, the hippocampus—a mind area essential to reminiscence—struggles to start new neurons, which assist preserve reminiscence and temper. All these modifications contribute to temper issues.

Basic antidepressants and newer therapies, together with ketamine, reverse depressive signs by serving to neurons regrow their branches. Preliminary research in mice counsel GLP-1-like medication additionally rewire mind areas that shrivel with despair and alleviate manic signs in bipolar mice. Whereas nonetheless preliminary, these outcomes pave the way in which for additional testing in people.

Alzheimer’s Illness

Dementia is a grueling journey for these struggling signs and their households. Neurodegenerative issues, similar to Alzheimer’s or Parkinson’s illness, slowly eat away at reminiscences, reasoning, and finally take lives. Continual irritation, which damages neurons and blood vessels and is linked to uncontrolled ranges of blood sugar, is a significant participant.

As a result of Ozempic and related medication decrease blood sugar, they might doubtlessly additionally dampen irritation within the Alzheimer’s mind and sluggish the lack of cognition. A couple of trials are within the works. Novo Nordisk, the Danish pharmaceutical big behind Ozempic and Wegovy, launched two medical trials in 2021 to see if semaglutide slows cognitive decline in Alzheimer’s sufferers. First outcomes are anticipated in 2025. In the meantime, a number of firms, together with Neuraly and Kariya Prescription drugs, are testing whether or not GLP-1 mimicking medication can restore cognition in Parkinson’s illness.

For now, we don’t absolutely perceive how these medication work within the mind. They might alter ldl cholesterol metabolism—a vital course of by which neurons construct their protecting sheaths. GLP-1 additionally reworks the way in which neurons join with one another to type purposeful networks, which might be how Ozempic and related medication work within the mind.

Whether or not the results final is one other thriller. Early outcomes for weight problems counsel GLP-1 mimics aren’t “eternally medication,” in that the sufferers’ weight partly bounces again after discontinuing the day by day regime. As for the mind? Solely time will inform.

Picture Credit score: NIH

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