Eventos adversos neuropsiquiátricos relacionados ao uso de agonistas do receptor de GLP-1: Uma revisão sistemática

Ana Carolina Parahyba Asfor; Ticihana Ribeiro de Oliveira; Matheus Eugênio de Sousa Lima

doi:10.59487/2965-1956-4-16811

Autores/as

Ana Carolina Parahyba Asfor Hospital de Saúde Mental Professor Frota Pinto https://orcid.org/0009-0004-0854-7059
Ticihana Ribeiro de Oliveira Hospital de Saúde Mental Professor Frota Pinto https://orcid.org/0009-0004-6106-1322
Matheus Eugênio de Sousa Lima Hospital de Saúde Mental Professor Frota Pinto https://orcid.org/0000-0003-0455-7079

DOI:

https://doi.org/10.59487/2965-1956-4-16811

Palabras clave:

Agonistas Receptor de Péptidos Similares al Glucagón, Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos, Trastornos Mentales

Resumen

Objetivo: Evaluar los principales eventos adversos neuropsiquiátricos asociados al uso de agonistas del receptor de GLP-1. Metodología: Esta revisión sistemática analizó artículos publicados entre 2019 y 2025 en las bases de datos PubMed y Medline, utilizando los términos de búsqueda “GLP-1 agonist”, “mental disorders” y “adverse effects”. Se incluyeron estudios observacionales y experimentales. Se seleccionaron nueve artículos con distintos diseños, como farmacovigilancia, cohortes retrospectivas, randomización mendeliana y análisis post hoc de ensayos clínicos. Resultados: Los estudios de farmacovigilancia identificaron una posible asociación entre agonistas del receptor de GLP-1 y eventos adversos neuropsiquiátricos. En los análisis con semaglutida se observaron razones de posibilidades ajustadas de 1,70 para depresión, 1,26 para ansiedad y 1,45 para conducta suicida. Otro estudio indicó una razón de 2,55 para ideación suicida en usuarios de semaglutida para pérdida de peso, además de informes de trastornos alimentarios. En contraste, los análisis post hoc de ensayos clínicos no mostraron diferencias significativas en síntomas depresivos ni ideación suicida frente al placebo. Los estudios de randomización mendeliana sugirieron un riesgo reducido de activación del receptor de GLP-1 para esquizofrenia, trastorno bipolar y bulimia nerviosa, y un estudio transversal asoció la semaglutida con una reducción de los síntomas de ansiedad y depresión. Conclusión: La relación causal entre los agonistas del receptor de GLP-1 y los eventos adversos neuropsiquiátricos graves no está completamente establecida. La heterogeneidad metodológica y los factores de confusión explican las discrepancias: mientras los estudios de farmacovigilancia generan alertas, los diseños más controlados no confirman la causalidad. Se recomienda el monitoreo activo de los pacientes en tratamiento y se requieren ensayos clínicos aleatorizados de mayor escala para esclarecer la relación riesgo-beneficio de estos fármacos.

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Biografía del autor/a

Ana Carolina Parahyba Asfor, Hospital de Saúde Mental Professor Frota Pinto

Médica psiquiatra. Hospital de Saúde Mental Frota Pinto, Preceptora/Assistente da Residência em Psiquiatria do HSMFP.

Ticihana Ribeiro de Oliveira, Hospital de Saúde Mental Professor Frota Pinto

Doutora em Saúde Coletiva. Hospital de Saúde Mental Professor Frota Pinto. Nutricionista do ambulatório de Nutrição e transtornos mentais. Fortaleza – Ceará, Brasil.

Matheus Eugênio de Sousa Lima, Hospital de Saúde Mental Professor Frota Pinto

Mestrando em Ciências Médicas. Médico Psiquiatra. Hospital de Saúde Mental Professor Frota Pinto. Preceptor/Assistente da Residência em Psiquiatria

Citas

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