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Use of Glucagon-Like Peptide 1 receptor agonists and the associated risk of hospitalization in Bipolar Disorder, from a nationwide cohort, 2009–2024
The intersection of diabetes, obesity, and bipolar disorder poses significant challenges, suggesting potential common underlying mechanisms. Glucagon-like peptide 1 receptor agonists (GLP-1RAs), effective in managing diabetes and obesity, have not been thoroughly examined concerning their effects on bipolar disorder. This research aimed to assess psychiatric hospitalizations and work absences due to sick leave in individuals diagnosed with bipolar disorder who received antidiabetic treatments, specifically focusing on GLP-1RAs.
The analysis involved a cohort sourced from the National Swedish Registers, comprising all individuals diagnosed with bipolar disorder who utilized antidiabetic medications from 2009 to 2024. The study compared users of GLP-1RAs, noted individually and collectively, against non-users and other second-line antidiabetic medications. A within-individual approach was employed to mitigate confounding factors, with the primary outcome centered on psychiatric hospitalizations for any cause. Secondary outcomes included hospitalizations triggered by bipolar disorder relapses and psychiatric-related sick leaves. Researchers applied stratified Cox models to derive adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for their comparisons.
The study sample consisted of 14,694 participants, with 5,200 individuals using GLP-1RAs. Notably, semaglutide was found to be associated with a 21% decreased risk of psychiatric hospitalization (aHR 0.79, 95% CI 0.69–0.91) compared to periods when individuals did not use GLP-1RAs. Furthermore, semaglutide correlated with a 17% reduction in the risk of bipolar disorder relapses (aHR 0.83, 95% CI 0.69–0.99). Conversely, liraglutide and dulaglutide did not show significant associations with reduced hospitalization rates. Work absences due to psychiatric conditions did not show a significant connection with any of the antidiabetic medications examined.
In conclusion, among individuals affected by both bipolar disorder and diabetes or obesity, semaglutide appears to be linked to reduced psychiatric hospitalization rates when compared to periods without GLP-1RA usage. In contrast, liraglutide and dulaglutide did not demonstrate a similar effect, indicating that the observed benefits may not extend to the entire class of medications. Further investigation through randomized controlled trials is warranted to validate these findings.
Year: 2026
