Brief Report

Semaglutide and Effort-Based Decision-Making in Major Depressive Disorder

JAMA Psychiatry 10.1001/jamapsychiatry.2026.0594

April 29, 2026 at 11:00 AM EDT

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Does oral semaglutide improve reward-related dysfunction in a clinical population with major depressive disorder (MDD)?In this 16-week, double-blind, placebo-controlled, parallel-group, fixed-dose randomized clinical trial, semaglutide-treated participants exhibited a pattern of increased willingness to exert physical efforts with higher expected values of reward. Sensitivity to effort was significantly reduced by treatment with semaglutide.To our knowledge, this is the first study assessing the multidimensional effects of a glucagon-like peptide-1 receptor agonist on reward-related abnormalities in a population with MDD.

Corresponding Author: Rodrigo B. Mansur, University Health Network, University of Toronto, 399 Bathurst St, Toronto, ON M5T 2S8, Canada (rodrigo.mansur@uhn.ca).

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