Abstract
Background: Liraglutide is a once-daily injectable medication approved for the treatment of obesity. Hereby we report the feasibility, adherence and efficacy of liraglutide treatment in a sample of individuals with mood disorders and obesity.Methods and Sample: Twenty-nine patients with Bipolar or Major Depressive Disorder received liraglutide once daily subcutaneously at a dose gradually titrated from 0.6 to 3 mg. All patients were obese and had previously failed multiple healthy lifestyle interventions, including exercise and diet programs. Patients' weight was recorded before liraglutide treatment (T0) and then 1 (T1), 3 (T3), and 6 months (T6) following T0.Results: Mean baseline (T0) weight was 110.54 Kg (±24.95). Compared to baseline, the percentage of weight loss was 3.37% at T1, 7.85% at T3, and 10.20% at T6. Thirty-one percent (n = 9) of patients had no side effects, 34.48% (n = 10) had one, 24.14% (n = 7) had two, and 10.34% (n = 3) had three side effects. All 29 subjects were still on liraglutide at T1; 79.31 and 48.28% were on liraglutide at T3 and T6. No significant relationship was found between liraglutide dose and likelihood to continue the medication. No patient showed a worsening of the psychiatric condition due to liraglutide treatment. Acceptability and satisfaction with treatment were good for the 48% that completed the study.Conclusions: Liraglutide treatment was efficacious, accepted and tolerated by ~50% of our sample, followed up for a period of 180 days. Larger, longer, controlled, prospective studies are warranted.
Highlights
Several studies have pointed to a link between cardiovascular diseases, obesity or metabolic syndrome among patients suffering from severe psychiatric disorders [1].For instance, patients suffering from depression, bipolar disorder and schizophrenia have 53% higher chance of cardiovascular disease, comparing to persons without psychiatric disorders, and Liraglutide in Mood Disorders their life expectancy is decreased by at least one or two decades [2]
Weiner and associates found that the risk of cardiovascular mortality is twice as larger among persons with diagnosed bipolar disorder compared to general population [3]
The high prevalence of obesity, metabolic syndrome and cardiovascular disease among patients diagnosed with major psychiatric disorders may be a result of genetic factors, inadequate lifestyles, such as poor dietary habits, lack of physical activity and tobacco smoking, adverse effects of psychotropic drugs, and environmental factor [4]
Summary
Several studies have pointed to a link between cardiovascular diseases, obesity or metabolic syndrome among patients suffering from severe psychiatric disorders [1].For instance, patients suffering from depression, bipolar disorder and schizophrenia have 53% higher chance of cardiovascular disease, comparing to persons without psychiatric disorders, and Liraglutide in Mood Disorders their life expectancy is decreased by at least one or two decades [2]. Liraglutide is an agonist of the acylated human GlucagonLike-Peptide-1 (GLP-1) receptor with 97% of sequence homology with naturally produced GLP-1 This medication is the first oncedaily injectable derivative of the human incretin glucagon-like peptide-1 recently approved by the European Medicines Agency (EMA) and the United States Food and Drug Administration (FDA) for the treatment of obesity (adults with a BMI ≥ 30 kg/m2), as well for adults with a BMI of 27 kg/m2 or greater who have one or more complications related to their weight, such as type 2 diabetes, high blood pressure, high cholesterol or obstructive sleep apnea [6, 7]. Liraglutide reduces body weight as well fatty mass through mechanisms that decrease the need for food and energy intake This agent improves glycemic control by reducing sugar levels in patients with type 2 diabetes mellitus [8]. Hereby we report the feasibility, adherence and efficacy of liraglutide treatment in a sample of individuals with mood disorders and obesity
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