Glucagon-like peptide-1 receptor agonists and Wernicke encephalopathy: A pharmacovigilance study and literature review

Jan 14, 2026Clinical nutrition (Edinburgh, Scotland)

Possible links between diabetes drugs that activate the GLP-1 receptor and Wernicke encephalopathy: Drug safety data and case reports

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

Fifteen cases of Wernicke encephalopathy (WE) associated with GLP-1 receptor agonists were identified.

Most cases occurred with semaglutide (8) or tirzepatide (6) and were reported between 2023-2024.
Thirteen patients experienced gastrointestinal symptoms such as weight loss, vomiting, loss of appetite, or malnutrition.
Classic symptoms of WE were reported in 11 patients, with the full clinical triad observed in 2 patients.
Long-term neurological consequences were noted in 7 out of 11 patients who had follow-up data.
Disproportionality analysis indicated an increased reporting of WE with GLP-1 receptor agonists compared to other medications (ROR = 2.35).

AI simplified

BACKGROUND & AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have revolutionized the treatment of type 2 diabetes mellitus and obesity in recent years. While gastrointestinal adverse events are common, their association with nutritional deficiencies, including thiamine, has not been comprehensively investigated. This study aimed to evaluate whether treatment with GLP-1 RAs is associated with the occurrence of Wernicke encephalopathy (WE).

METHODS: We conducted a pharmacovigilance study using the FDA Adverse Event Reporting System (FAERS) and a narrative literature review. Disproportionality analysis assessed WE reporting following GLP-1 RA treatment using the reporting odds ratio (ROR) and the lower bound of the information component (IC) 95 % credibility interval.

RESULTS: We identified 15 cases of GLP-1 RA-associated WE: 13 from FAERS, 1 from published literature, and 1 from our medical center. Most cases occurred with semaglutide (n = 8/15) or tirzepatide (6/15), and were reported in 2023-2024 (14/15). Most patients (13/15) reported gastrointestinal manifestations of either weight loss, vomiting, loss of appetite, or malnutrition. Classic WE symptoms were reported in 11 patients, and the full clinical triad in 2 patients. Long-term neurological sequelae were noted in 7 of 11 patients with follow-up data. Disproportionality analysis showed increased reporting of WE with GLP-1 RAs compared with other medications (ROR = 2.35 [95%CI, 1.38-4.01]; IC= 0.29). 25

CONCLUSIONS: WE is a potentially rare but severe adverse event of GLP-1 RA treatment, mainly with semaglutide or tirzepatide. As early detection may prevent neurological sequelae, increased clinical awareness is warranted, especially in individuals experiencing severe gastrointestinal symptoms.

Full Text

Full text is available at the source.

View full text (XML) ↗View full text ↗

Glucagon-like peptide-1 receptor agonists and Wernicke encephalopathy: A pharmacovigilance study and literature review

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief