Semaglutide for Depression Patients: Evidence, Eligibility
Semaglutide is not FDA approved for depression. It is approved for type 2 diabetes, heart risk and kidney disease in type 2 diabetes. Some doctors prescribe it when one of those uses also applies. In STEP 1, people on Wegovy lost 14.9% of body weight on average, vs 2.4% on placebo.
- Brands
- Ozempic, Wegovy and Rybelsus
- Best result (STEP 1)
- 14.9% weight loss
Wegovy in brief
Its half-life runs about 1 week: by 7 d, half of it has cleared, and roughly 3% remains after five half-lives (35 d).
Over 68 weeks in STEP 1, 14.9% of body weight was lost, against 2.4% on placebo.
The maker's price page lists monthly amounts in US dollars, covering both the list price and self-pay options.
Sources: FDA label (DailyMed), healthsystemtracker.org, prnewswire.com 1 2.
Who qualifies?
| Who sets the rule | Who qualifies |
|---|---|
 Ozempic | It lowers blood sugar in adults with type 2 diabetes when used with diet and exercise. |
| Ozempic | Heart disease plus type 2 diabetes: it lowers the risk of heart attack, stroke, and heart-related death in those adults. |
| Ozempic | For adults who have chronic kidney disease along with type 2 diabetes, this medicine reduces the risk of kidney failure, heart-related death and worsening kidney disease. |
 Wegovy | For adults with heart disease and either obesity or overweight, both forms reduce the risk of heart-related death, stroke, or heart attack. |
| Wegovy | Long-term weight loss and weight maintenance through diet and activity are the goals. The groups are adults with obesity, children 12 and older with obesity, and adults with overweight plus a weight-related condition. |
| Wegovy | The injection treats MASH liver disease in adults whose condition has moderate to advanced scarring but no cirrhosis. |
| Wegovy | For adults, these tablets are approved for weight loss and heart risk. |
 Rybelsus | It lowers blood sugar in adults with type 2 diabetes when used with diet and exercise. |
| Rybelsus | For adults with type 2 diabetes who are high risk, it lowers the risks of heart attack, stroke, and heart-related death. |
| Medicare GLP-1 Bridge | BMI 35 or higher, no condition needed |
| Medicare GLP-1 Bridge | A BMI of 30 or higher is needed, and also one of: heart failure, uncontrolled blood pressure, CKD 3a+ |
| Medicare GLP-1 Bridge | A BMI of 27 or higher is needed, and also one of: prediabetes, prior heart attack or stroke, PAD |
| Typical commercial plan (Aetna policy) | BMI 30 or higher |
| Typical commercial plan (Aetna policy) | BMI 27 or higher with a weight-related condition |
| Typical commercial plan (Aetna policy) | a diet and activity program runs first for 6 months |
Sources: FDA label (DailyMed) with references 1, 2, 3; medicare.gov with references 1, 2; aetna.com.
Trial results for depression
None of these studies enrolled people with depression alone. Participants were adults with obesity or overweight, and none had diabetes.
| Trial | Medicine | Who took part | Length | People | Main result | Comparison |
|---|---|---|---|---|---|---|
| STEP 1 | Wegovy | Adults with obesity or overweight, without diabetes | 68 weeks | 1,961 | 14.9% weight loss | 2.4% on placebo |
| OASIS 4 | Wegovy | Adults with obesity or overweight, without diabetes | 64 weeks | 307 | 13.6% weight loss | 2.4% on placebo |
The study source is STEP 1 (FDA label (DailyMed)).
What is different when depression is involved?
| What changes | What the label says | Labels |
|---|---|---|
| Severe Gastrointestinal Adverse Reactions | Side effects in the stomach and gut happen often and can be severe. Not recommended for people with severe gastroparesis. | All of them |
Labels from the FDA: FDA label (DailyMed).
Warnings listed in the FDA label (DailyMed).
Coverage for depression
Medicare Part D does not pay for a GLP-1 used only for weight loss.
People who meet the rules can find Wegovy on the Medicare GLP-1 Bridge for $50 per month.
Prior authorization is the norm wherever Medicaid pays for weight-loss GLP-1s.
Sources: humana.com, CMS, KFF.
- Semaglutide Cost Without Insurance
- Semaglutide Coupons
- Semaglutide Insurance Coverage
- Does Medicaid Cover Semaglutide? Wegovy and Ozempic by State
- Does Blue Cross Blue Shield Cover Semaglutide? Criteria, Copay
- Does UnitedHealthcare Cover Semaglutide? Criteria, Copay, Appeals
- Ozempic Coupon
- Ozempic Cost
- Ozempic Cost Without Insurance
Alternatives for depression
| Medicine | For people with depression | How it is taken | Trial result |
|---|---|---|---|
| Ozempic | Not a listed use | weekly injection | Not listed |
| Wegovy | Not a listed use | weekly injection or daily tablet | 14.9% weight loss |
| Rybelsus | Not a listed use | daily tablet | Not listed |
 Mounjaro | Not a listed use | weekly injection | Not listed |
 Zepbound | Not a listed use | weekly injection | 20.9% weight loss |
 Foundayo | Not a listed use | daily tablet | 11.1% weight loss |
 Trulicity | Not a listed use | weekly injection | Not listed |
 Saxenda | Not a listed use | daily injection | 7.4% weight loss |
 Victoza | Not a listed use | daily injection | Not listed |
| Byetta | Not a listed use | twice-daily injection | Not listed |
Source: FDA DailyMed label.
Questions to ask your prescriber
- Could this interact with my antidepressant?
- Who should I call if my mood changes?