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 authorised, 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 self-importance.
It’s no marvel. Weight loss supplements have an extended and tumultuous historical past. From amphetamine-laden “rainbow tablets” to the infamous fen-phen and its lethal uncomfortable side effects within the lungs and coronary heart, these tablets have a killer fame.
Scientists have lengthy looked for a protected and efficient tablet 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 fighting weight problems, the drug is a possible lifesaver. Extra weight is related to larger incidences of stroke, coronary heart and liver illness, sleep apnea, joint issues, and a few cancers. A serious scientific trial this yr in tens of 1000’s of chubby individuals with out diabetes discovered the principle ingredient in Ozempic, semaglutide, lowered the danger of stroke and coronary heart assault, whereas reducing the probabilities of dying as a consequence of cardiovascular issues.
Maybe much more importantly, the drug is step by step altering societal views on weight problems—it’s not as a consequence of lack of will energy, however a power 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 problems, together with Alzheimer’s and Parkinson’s. Medical trials are underway for habit, and the medication are displaying early promise battling bipolar dysfunction and melancholy.
Intestine to Mind
Why would medication helpful within the therapy of diabetes and weight reduction additionally show efficient for temper, habit, and neurodegenerative illnesses?
It comes all the way down to how Ozempic and Wegovy work. Each comprise semaglutide, a chemical that mimics a hormone known 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 examine—sustaining a metabolic state that’s vital 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 usually rejects giant molecules that might harm its delicate neurons, nevertheless it readily admits GLP-1. The hormone prompts neurons in a variety of mind areas, together with the “reward heart” and hippocampus, which play vital roles within the regulation of temper and reminiscence.
This has neuroscientists questioning: Can GLP-1 tweak mind perform to help neurological or psychological well being?
Habit
One tantalizing facet impact of individuals taking GLP-1-like medication has been that they’re much less enthusiastic about consuming alcohol and different mind-bending substances. Why this occurs is unclear, nevertheless it’s seemingly as a result of the hormone dampens reward pathways within the mind.
One examine, 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 therapy, these injected with GLP-1-like medication lowered their alcohol consumption even when tempted with all-you-can-drink alcohol. As a substitute, they readily slurped recent water.
GLP-1 mimics may additionally assist curb smoking habit. A small scientific trial in 2021 discovered people who smoke, whereas sporting nicotine patches, readily kicked the behavior when injected with a first-generation GLP-1 drug. Almost half of the GLP-1 handled individuals stop smoking—a hit charge nearly double that of a management group that solely wore nicotine patches.
As with all new drug, the outcomes aren’t reduce and dried. One examine 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
Melancholy and different temper problems are additionally doable targets for GLP-1 mimics.
Usually thought of purely neurological, temper is tightly linked to different elements of the physique, together with the intestine. Individuals with melancholy usually expertise adjustments in urge for food and intestine hormone ranges—together with GLP-1.
An evaluation of six trials with over 2,000 individuals discovered GLP-1 mimicking medication eased their melancholy. One other trial involving 29 individuals with bipolar dysfunction or melancholy discovered the medication leveled temper swings for at the very least six months after therapy.
The medication might work by altering neural connections within the mind.
Neurons look a bit like bushes, with large 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 kind wholesome networks. What’s extra, the hippocampus—a mind area vital to reminiscence—struggles to delivery new neurons, which assist keep reminiscence and temper. All these adjustments contribute to temper problems.
Traditional 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 melancholy and alleviate manic signs in bipolar mice. Whereas nonetheless preliminary, these outcomes pave the best way for additional testing in people.
Alzheimer’s Illness
Dementia is a grueling journey for these struggling signs and their households. Neurodegenerative problems, comparable to Alzheimer’s or Parkinson’s illness, slowly eat away at reminiscences, reasoning, and finally take lives. Persistent 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 probably additionally dampen irritation within the Alzheimer’s mind and sluggish the lack of cognition. Just a few trials are within the works. Novo Nordisk, the Danish pharmaceutical large behind Ozempic and Wegovy, launched two scientific 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 Prescribed drugs, are testing whether or not GLP-1 mimicking medication can restore cognition in Parkinson’s illness.
For now, we don’t totally 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 best way neurons join with one another to kind practical networks, which may very well be how Ozempic and related medication work within the mind.
Whether or not the consequences final is one other thriller. Early outcomes for weight problems counsel GLP-1 mimics aren’t “without end medication,” in that the sufferers’ weight partly bounces again after discontinuing the each day regime. As for the mind? Solely time will inform.
Picture Credit score: NIH