GLP-1 Drug Users Need Fewer Doctor Visits for Depression and Anxiety Than Those on Older Diabetes Drugs | Research

The takeaway

A study of nearly 775,000 adults found GLP-1 drugs were associated with 13–15% fewer office visits for depression and anxiety compared to DPP-4 inhibitors.

15% fewer anxiety-related office visits
Adults with type 2 diabetes who started GLP-1 drugs had significantly fewer office visits for anxiety over 12 months compared to those starting DPP-4 inhibitors

What the researchers found

In a retrospective cohort of 774,968 adults with T2DM, GLP-1 receptor agonist initiation was associated with significantly reduced mental health-related healthcare utilization compared to DPP-4 inhibitor initiation:

- Office visits for depression: IRR 0.87 (95% CI 0.82–0.92) — 13% reduction

- Office visits for anxiety: IRR 0.85 (95% CI 0.81–0.90) — 15% reduction

- Outpatient hospital visits for depression: IRR 0.96 (95% CI 0.95–0.98) — 4% reduction

No significant changes were observed for emergency department or inpatient visits. Reductions were more pronounced with semaglutide, liraglutide, and dulaglutide specifically.

Why it matters

Depression and anxiety affect up to 40% of people with type 2 diabetes, worsening their health outcomes and driving up healthcare costs. If GLP-1 drugs can reduce the mental health burden alongside their metabolic benefits, this represents a significant additional value proposition. This large real-world study provides early evidence that the mental health benefits observed in smaller studies may translate into measurable reductions in healthcare utilization at a population level.

How the study worked

This was a retrospective cohort study using the Komodo Healthcare Map, a national database of pharmacy and medical claims. Adults who initiated GLP-1 receptor agonists or DPP-4 inhibitors between January 2019 and March 2022 were included (n=774,968). Patients were followed for 12 months after medication initiation. A difference-in-differences analysis compared mental health-related healthcare resource utilization (HCRU) before and after initiation, adjusting for sociodemographic and clinical variables. Outcomes included emergency department, inpatient, outpatient hospital, and office visits for depression and anxiety.

What this study cannot tell us

This is an observational study using claims data, which cannot establish causation. Reduced mental health visits could reflect improved mental health OR reduced access/engagement with care. Claims data lacks clinical detail — we don't know if patients actually felt less depressed or anxious. There may be selection bias: patients prescribed GLP-1 drugs may differ systematically from those prescribed DPP-4 inhibitors. The 12-month follow-up is relatively short. Emergency and inpatient visits showed no change, which could indicate the benefit is limited to milder presentations.

How to read the evidence

This is a large retrospective cohort study using national claims data with a difference-in-differences design, which is a relatively strong observational methodology. However, claims data lacks clinical outcome measurements, and the study cannot establish causation. The very large sample size provides statistical power but also means clinically small differences can reach significance.

When this study was published

Published in 2025 with data from 2019–2023, this is a very current study capturing the period of rapid GLP-1 drug adoption. The findings are timely as researchers investigate the broader effects of these increasingly popular medications.

The bigger picture

This study contributes to the rapidly growing evidence that GLP-1 drugs have effects beyond metabolism. The brain has GLP-1 receptors, and these drugs cross the blood-brain barrier, providing a biological mechanism for mental health effects. If confirmed, the mental health benefits could reshape how GLP-1 drugs are valued by health systems and insurers, adding a mental health dimension to their already proven cardiovascular, renal, and metabolic benefits.

Questions still open

Do GLP-1 drugs actually improve depression and anxiety symptoms, or do patients simply visit the doctor less for mental health while on these medications?
Is the mental health benefit driven by the direct neurological effects of GLP-1 drugs, by the psychological impact of weight loss, or by improved glycemic control?
Would the mental health benefits of GLP-1 drugs be even more pronounced in patients without diabetes who take them solely for weight loss?

Common questions

Does this mean GLP-1 drugs treat depression and anxiety?

Not necessarily. This study shows that people on GLP-1 drugs visited the doctor less often for depression and anxiety compared to those on older diabetes drugs. But fewer visits don't automatically mean better mental health — they could reflect many factors. Controlled clinical trials specifically measuring depression and anxiety symptoms are needed before any claims about mental health treatment can be made.

Why might GLP-1 drugs affect mental health?

There are several possible explanations. GLP-1 receptors exist in brain areas that regulate mood, so the drugs may have direct neurological effects. Weight loss itself can improve self-esteem and reduce depression. Better blood sugar control reduces fatigue and mood swings. Or it could be a combination of all these factors. Ongoing research is working to untangle these mechanisms.

Read the original research

Glucagon-Like Peptide-1 Use and Healthcare Resource Utilization for Depression and Anxiety Among Adults with Type 2 Diabetes: 2019 to 2023.

The journal of behavioral health services & research

View on PubMed ↗Publisher’s paper ↗

Citation

Do, Duy; Lee, Tiffany; Inneh, Angela; Patel, Urvashi. (2025). Glucagon-Like Peptide-1 Use and Healthcare Resource Utilization for Depression and Anxiety Among Adults with Type 2 Diabetes: 2019 to 2023.. The journal of behavioral health services & research. https://doi.org/10.1007/s11414-025-09950-6