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与胰高血糖素样肽-1类似物相关的精神科不良事件:美国、加拿大和澳大利亚不良事件数据库中的不成比例性分析

Psychiatric adverse events linked to glucagon-like peptide 1 analogues: a disproportionality analysis in American, Canadian and Australian adverse event databases.

作者信息

Katranski Jonah, Liang Sihua, Morris Deirdre, Suppiah Vijayaprakash, Lim Chiao Xin

机构信息

Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.

Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia.

出版信息

Int J Clin Pharm. 2025 Jun 16. doi: 10.1007/s11096-025-01943-x.

Abstract

BACKGROUND

Glucagon-like peptide 1 (GLP-1) analogues are a class of medications that stimulate glucose-dependent insulin release and slow gastric emptying. With the increasing use of GLP-1 analogues, concerns about potential psychiatric adverse events (AEs) remain under-explored.

AIM

This pharmacovigilance study aimed to investigate the prevalence of psychiatric AEs associated with currently available GLP-1 analogues by analysing publicly available national datasets from the US (FAERS), Canada (CVAROD) and Australia (DAEN).

METHOD

Psychiatric AE reports were extracted from all three databases for all approved GLP-1 analogues. A disproportionality analysis was conducted to calculate reporting odds ratios (RORs) and 95% confidence intervals (CIs) for psychiatric AEs of interest.

RESULTS

Significant associations were identified when multiple databases reported elevated RORs. Semaglutide was associated with depressive symptoms (FAERS, ROR = 6.24 CI 4.49-8.69), panic attacks (FAERS, ROR = 1.46 CI 1.16-1.82) and suicidal ideation (FAERS, ROR = 2.58 CI 2.31-2.88). Liraglutide was linked to depression (CVAROD, ROR = 1.68 CI 1.12-2.51), while dulaglutide showed positive associations with eating disorders (FAERS, ROR = 1.47 CI 1.26-1.71) and insomnia (FAERS, ROR = 2.93 CI 2.35-3.66).

CONCLUSION

GLP-1 analogues, particularly semaglutide and liraglutide, are associated with significant psychiatric AEs, especially depression and suicidal ideation. Further studies are required to understand the mechanisms underlying these associations, particularly in patients with pre-existing psychiatric conditions.

摘要

背景

胰高血糖素样肽-1(GLP-1)类似物是一类可刺激葡萄糖依赖性胰岛素释放并延缓胃排空的药物。随着GLP-1类似物使用的增加,对潜在精神科不良事件(AE)的担忧仍未得到充分研究。

目的

这项药物警戒研究旨在通过分析来自美国(FAERS)、加拿大(CVAROD)和澳大利亚(DAEN)的公开可用国家数据集,调查与目前可用的GLP-1类似物相关的精神科AE的患病率。

方法

从所有三个数据库中提取所有已批准的GLP-1类似物的精神科AE报告。进行不成比例分析以计算感兴趣的精神科AE的报告比值比(ROR)和95%置信区间(CI)。

结果

当多个数据库报告ROR升高时,发现了显著关联。司美格鲁肽与抑郁症状(FAERS,ROR = 6.24,CI 4.49 - 8.69)、惊恐发作(FAERS,ROR = 1.46,CI 1.16 - 1.82)和自杀意念(FAERS,ROR = 2.58,CI 2.31 - 2.88)相关。利拉鲁肽与抑郁症有关(CVAROD,ROR = 1.68,CI 1.12 - 2.51),而度拉鲁肽与饮食失调(FAERS,ROR = 1.47,CI 1.26 - 1.71)和失眠(FAERS,ROR = 2.93,CI 2.35 - 3.66)呈正相关。

结论

GLP-1类似物,尤其是司美格鲁肽和利拉鲁肽,与显著的精神科AE相关,尤其是抑郁症和自杀意念。需要进一步研究以了解这些关联背后的机制,特别是在已有精神疾病的患者中。

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