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However, conflicting evidence from preclinical, clinical, and pharmacovigilance studies suggests potential neuropsychiatric effects. This study examined associations between GLP\u20101RA use and initiation of a range of neuropsychiatric medications using real\u2010world prescription data. A Prescription Sequence Symmetry Analysis was conducted using Australia's Pharmaceutical Benefits Scheme\u00a010% random sample between July 1, 2013 and December 31, 2024. Individuals with an incident dispensing of both a GLP\u20101RA and a neuropsychiatric medication were included. Outcomes comprised antidepressants, medication for substance use disorder (SUD), antipsychotics, psychostimulants, antidementia medications, antiparkinsonian medications, antiepileptics, and antimigraine agents. Adjusted sequence ratios (aSRs) with 95% confidence intervals (CIs) were calculated using a one\u2010year exposure window, with sensitivity analyses varying various time windows. Among 2,033 individuals, semaglutide was the most common GLP\u20101RA (50.6%), followed by exenatide (27.5%) and dulaglutide (21.9%). GLP\u20101RA initiation was inversely associated with initiation of antidepressants (aSR: 0.85; 95% CI: 0.76\u20130.94) and medications for SUD (aSR: 0.70; 95% CI: 0.51\u20130.88). No significant associations were observed for other neuropsychiatric outcomes. GLP\u20101RA use was inversely associated with subsequent initiation of antidepressants and medications for SUD, while no associations were identified for other neuropsychiatric marker medications. These findings highlight the need for further studies to clarify the nature and magnitude of these potential neuropsychiatric associations with GLP\u20101RAs.<\/jats:p>","DOI":"10.1002\/cpt.70414","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:36:01Z","timestamp":1785479761000},"page":"1092-1100","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prescription Sequence Symmetry Analysis of Glucagon\u2010Like Peptide\u20101 Receptor Agonists and Neuropsychiatric Conditions"],"prefix":"10.1002","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1411-110X","authenticated-orcid":false,"given":"Maria J.","family":"Alfonso Arvez","sequence":"first","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences Monash University  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4680-8514","authenticated-orcid":false,"given":"Sam","family":"Wade","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences Monash University  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6381-8745","authenticated-orcid":false,"given":"Darshna","family":"Goordeen","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences Monash University  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0348-9441","authenticated-orcid":false,"given":"Jenni","family":"Ilom\u00e4ki","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences Monash University  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6001-9211","authenticated-orcid":false,"given":"Amanda J.","family":"Cross","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences Monash University  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0719-8999","authenticated-orcid":false,"given":"Monica","family":"Langiu","sequence":"additional","affiliation":[{"name":"Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences Monash University  Parkville Victoria Australia"},{"name":"AK Clinical Research  Carlton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2526-729X","authenticated-orcid":false,"given":"George S. 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