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2型糖尿病患者中与利拉鲁肽相关的抑郁:一例病例报告及讨论

Liraglutide-associated depression in a patient with type 2 diabetes: A case report and discussion.

作者信息

He Yangliuqing, Liang Fenrong, Wang Yiming, Wei Yuhan, Ma Tianpei

机构信息

Clinical Medicine College of Guizhou Medical University, Guiyang, China.

Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, China.

出版信息

Medicine (Baltimore). 2024 May 3;103(18):e37928. doi: 10.1097/MD.0000000000037928.

Abstract

BACKGROUND

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) like liraglutide are primarily used for managing blood sugar levels in type 2 diabetes and aiding weight loss. Typically, their adverse effects are gastrointestinal, with limited exploration into their impact on mental health.

CASE PRESENTATION

This report examines a 39-year-old male with type 2 diabetes who developed depressive symptoms after starting liraglutide for glycemic control and weight reduction. Symptoms included poor mood, irritability, decreased interest and energy, progressing to sadness, low self-esteem, and physical discomfort. A clinical diagnosis of a depressive episode was made, coinciding with the initiation of liraglutide.

INTERVENTION AND OUTCOME

The patient depressive symptoms significantly improved within a week after discontinuing liraglutide and starting antidepressant therapy. This suggests a possible link between liraglutide and depression, despite considering other factors like diabetes-related stress.

DISCUSSION

The report explores potential mechanisms, such as GLP-1RA effects on glucose fluctuations and dopamine modulation, which might contribute to depressive symptoms. The influence on the brain reward system and the reduction in cravings for addictive substances after GLP-1RA use is also discussed as a factor in mood regulation.

CONCLUSION

This case highlights the necessity of being vigilant about potential psychiatric side effects, particularly depression, associated with GLP-1RAs. The rarity of such reports calls for more research to investigate and understand these implications further.

摘要

背景

利拉鲁肽等胰高血糖素样肽-1受体激动剂(GLP-1RAs)主要用于控制2型糖尿病患者的血糖水平并辅助减肥。通常,其不良反应主要是胃肠道方面的,对其对心理健康影响的研究有限。

病例介绍

本报告研究了一名39岁的2型糖尿病男性患者,该患者在开始使用利拉鲁肽控制血糖和减轻体重后出现了抑郁症状。症状包括情绪低落、易怒、兴趣和精力下降,进而发展为悲伤、自卑和身体不适。在开始使用利拉鲁肽时,临床诊断为抑郁发作。

干预与结果

在停用利拉鲁肽并开始抗抑郁治疗后的一周内,患者的抑郁症状明显改善。这表明利拉鲁肽与抑郁症之间可能存在联系,尽管考虑了糖尿病相关压力等其他因素。

讨论

该报告探讨了潜在机制,如GLP-1RA对血糖波动的影响和多巴胺调节,这可能导致抑郁症状。GLP-1RA使用后对大脑奖励系统的影响以及对成瘾物质渴望的减少也被讨论为情绪调节的一个因素。

结论

本病例强调了警惕与GLP-1RAs相关的潜在精神副作用,特别是抑郁症的必要性。此类报告的罕见性要求进行更多研究以进一步调查和了解这些影响。

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本文引用的文献

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Diabetes and mood disorders: shared mechanisms and therapeutic opportunities.糖尿病与心境障碍:共同的发病机制与治疗契机。
Int J Psychiatry Clin Pract. 2022 Jun;26(2):183-195. doi: 10.1080/13651501.2021.1957117. Epub 2021 Aug 4.

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