After Weight Loss, Ozempic Is Set to Conquer a Universe of Brain Disorders

Physicians were amazed at the drug’s efficacy in treating diabetes, for which it is FDA approved, and obesity. Social media propelled it into the year’s zeitgeist as a “Miracle” weight-loss drug that can help people effortlessly shed pounds-for health or for vanity.

For many people struggling with obesity, the drug is a potential lifesaver.

Perhaps even more importantly, the drug is gradually changing societal views on obesity-it’s not due to lack of will power, but a chronic medical condition that can be treated.

Ozempic and similar drugs-like Wegovy, another semaglutide-based medication that has been FDA-approved for weight loss-are already set for the next chapter: tackling a wide range of brain disorders, including Alzheimer’s and Parkinson’s.

Clinical trials are underway for addiction, and the drugs are showing early promise battling bipolar disorder and depression.

Why would drugs useful in the treatment of diabetes and weight loss also prove effective for mood, addiction, and neurodegenerative diseases?

GLP-1 doesn’t just roam the gut; it also easily enters the brain.

Protected by a tight-knit cellular barrier, the brain often rejects large molecules that could damage its sensitive neurons, but it readily admits GLP-1. The hormone activates neurons in a wide range of brain areas, including the “Reward center” and hippocampus, which play critical roles in the regulation of mood and memory.

This has neuroscientists wondering: Can GLP-1 tweak brain function to support neurological or mental health? One tantalizing side effect of people taking GLP-1-like drugs has been that they’re less interested in consuming alcohol and other mind-bending substances.

After two to five weeks of treatment, those injected with GLP-1-like drugs reduced their alcohol intake even when tempted with all-you-can-drink alcohol.

A small clinical trial in 2021 found smokers, while wearing nicotine patches, readily kicked the habit when injected with a first-generation GLP-1 drug. As with any new drug, the results aren’t cut and dried. One study for alcoholism using a first-generation GLP-1 mimic found little difference in people undergoing behavioural therapy.

Both groups lowered their alcohol consumption, but the GLP-1 drug didn’t further bolster recovery. A trial using the drug for cocaine abuse also found negligible effects. Clinical trials are in the works, some using brain-imaging to see how the brain reacts to the drug in real time.

People with depression often experience changes in appetite and gut hormone levels-including GLP-1. An analysis of six trials with over 2,000 participants found GLP-1 mimicking drugs eased their depression.

Another trial involving 29 people with bipolar disorder or depression found the drugs leveled mood swings for at least six months after treatment. The drugs could work by changing neural connections in the brain.

What’s more, the hippocampus-a brain region critical to memory-struggles to birth new neurons, which help maintain memory and mood.

Initial studies in mice suggest GLP-1-like drugs also rewire brain regions that shrivel with depression and alleviate manic symptoms in bipolar mice.

Because Ozempic and similar drugs lower blood sugar, they could potentially also dampen inflammation in the Alzheimer’s brain and slow the loss of cognition.

Multiple companies, including Neuraly and Kariya Pharmaceuticals, are testing whether GLP-1 mimicking drugs can restore cognition in Parkinson’s disease.

For now, we don’t fully understand how these drugs work in the brain.

GLP-1 also reworks the way neurons connect with each other to form functional networks, which could be how Ozempic and similar drugs work in the brain.

Early results for obesity suggest GLP-1 mimics aren’t “Forever drugs,” in that the patients’ weight partly bounces back after discontinuing the daily regime.