Eventos adversos neuropsiquiátricos relacionados ao uso de agonistas do receptor de GLP-1
Uma revisão sistemática
DOI:
https://doi.org/10.59487/2965-1956-4-16811Palavras-chave:
Agonistas do Receptor do Peptídeo 1 Semelhante ao Glucagon, Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos, Transtornos MentaisResumo
Objetivo: Avaliar os principais eventos adversos neuropsiquiátricos associados ao uso de agonistas do receptor de GLP-1. Metodologia: Esta revisão sistemática analisou artigos publicados entre 2019 e 2025 nas bases PubMed e Medline, utilizando os termos de busca “GLP-1 agonist”, “mental disorders” e “adverse effects”. Foram incluídos delineamentos observacionais e experimentais. Nove artigos foram selecionados, abrangendo delineamentos diversos, como farmacovigilância, coortes retrospectivas, randomização mendeliana e análises post hoc de ensaios clínicos. Resultados: Estudos de farmacovigilância identificaram possível associação entre agonistas do receptor de GLP-1 e eventos adversos neuropsiquiátricos. Em análises com semaglutida, observaram-se razões ajustadas de 1,70 para depressão, 1,26 para ansiedade e 1,45 para comportamento suicida. Outro estudo indicou razão de 2,55 para ideação suicida em usuários de semaglutida para perda de peso, além de relatos de transtornos alimentares. Em contraste, análises post hoc de ensaios clínicos não mostraram diferenças significativas em sintomas depressivos ou ideação suicida frente ao placebo. Estudos de randomização mendeliana sugeriram risco reduzido de ativação do receptor de GLP-1 para esquizofrenia, transtorno bipolar e bulimia nervosa, e um estudo transversal associou a semaglutida à redução de sintomas ansiosos e depressivos. Conclusão: A relação causal entre agonistas do receptor de GLP-1 e eventos adversos neuropsiquiátricos graves não está totalmente estabelecida. A heterogeneidade metodológica e fatores confundidores explicam as discrepâncias: enquanto estudos de farmacovigilância levantam alertas, estudos com delineamento mais controlado não confirmam causalidade. Recomenda-se o monitoramento ativo de pacientes em tratamento, sendo necessários ensaios clínicos randomizados de maior escala para elucidar a relação risco-benefício desses fármacos.
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Copyright (c) 2025 Ana Carolina Parahyba Asfor, Ticihana Ribeiro de Oliveira, Matheus Eugênio de Sousa Lima
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
