semaglutide (Wegovy)

Last reviewed 2026-02-12

Reviewed by PsychMed Editorial Team.

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Adjunctive therapy

Brands: WEGOVY

Sources updated 2026 • 4 references

Quick summary

General Information

Wegovy is a once-weekly injectable form of semaglutide (2.4 mg), a GLP-1 receptor agonist indicated for chronic weight management (with diet and exercise) in adults and certain adolescents (label).

Wegovy is not a psychiatric medication. In mental health care it is most often discussed when obesity/metabolic disease complicates treatment or when weight-gain–promoting psychotropics drive cardiometabolic risk (clinical).

Wegovy includes warnings that are particularly relevant to psychiatric populations: boxed warning for thyroid C-cell tumors and a warning to monitor for suicidal behavior and ideation (label).

The compare view, evidence feed, and print page help compare titration schedules and monitoring themes.

U.S. approvals

Chronic weight management in adults with obesity or overweight with weight-related comorbidities (2021)
Chronic weight management in adolescents (≥12 years) with obesity (with diet and exercise) (2022)

Formulations & strengths

Single-dose pens for subcutaneous injection once weekly (label).
Dose strengths support gradual titration to 2.4 mg once weekly maintenance (label).

Generic availability

Not available generically (brand-only).

Access is frequently shaped by insurance coverage, supply availability, and the ability to maintain follow-up during dose escalation. In psychiatric populations, aligning the plan with sustainable monitoring and support can be as important as the medication choice itself (clinical).

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Mechanism of Action

Refer to the Glossary entry on Neurotransmitters for background on receptor systems involved in serious mental illness.

Semaglutide is a GLP-1 receptor agonist. GLP-1 activity increases glucose-dependent insulin secretion, suppresses inappropriate glucagon, slows gastric emptying, and reduces appetite; weight loss is a core therapeutic outcome for Wegovy (label/clinical).

In mental health care, the practical aim is often lowering metabolic risk while maintaining psychiatric stability and medication adherence (clinical).

GLP-1 receptor agonism (incretin-based metabolic signaling).
Appetite and satiety effects (clinical framing).

Metabolism and Pharmacokinetics

Long half-life supports once-weekly dosing (approximately 7 days per label framing).
Major CYP-mediated interactions are not expected (peptide metabolism), but delayed gastric emptying can affect absorption of some oral drugs during titration (label/clinical).

Dosing and Administration

Typical: titrate to 2.4 mg subcutaneously once weekly for maintenance (0.25 mg weekly for 4 weeks → 0.5 mg weekly for 4 weeks → 1 mg weekly for 4 weeks → 1.7 mg weekly for 4 weeks → 2.4 mg weekly) (label).
If a dose is missed and the next scheduled dose is more than 48 hours away, administer as soon as possible; otherwise skip and resume the regular schedule (label).
Injection sites include abdomen, thigh, or upper arm; rotate sites (label).
Slower escalation (or temporary down-titration) is a common clinical strategy for persistent nausea during titration (clinical).

Monitoring & Labs

Weight/BMI and waist circumference trend; document baseline and track response over time (clinical).
Screen for disordered eating and monitor intake/hydration during titration (clinical).
Monitor for symptoms of pancreatitis and gallbladder disease (persistent severe abdominal pain, vomiting) (label).
Monitor for new or worsening depression, suicidal thoughts/behaviors, and unusual mood changes; discontinue if symptoms develop (label).
Monitor for dehydration and renal function concerns when significant GI losses occur (label/clinical).

Consider coordination with primary care/endocrinology for cardiometabolic monitoring and for diabetes regimen changes when applicable (clinical).

Adverse Effects

FDA boxed warnings

Risk of thyroid C-cell tumors in rodents; contraindicated with personal or family history of MTC or MEN2 (label).

Common side effects (≥10%)

Nausea / vomiting: Common during initiation and dose escalation; slower titration and meal-size adjustments often help (label/clinical).
Diarrhea / constipation: GI motility symptoms are common; hydration and dose pacing are common mitigations (label/clinical).
Decreased appetite: Appetite suppression is expected; monitor for dehydration and inadequate intake when symptoms are severe (clinical).
Injection-site reactions: Usually mild; rotate sites and monitor for persistent inflammation (label).

Other notable effects

Suicidal behavior and ideation warning: monitor for new or worsening depression, suicidal thoughts/behaviors, and unusual mood changes; discontinue if symptoms develop and avoid use in patients with active suicidal ideation (label).
Pancreatitis and gallbladder disease have been reported; evaluate severe or persistent abdominal pain and discontinue if pancreatitis is suspected (label).
Dehydration from vomiting/diarrhea can precipitate acute kidney injury; monitor volume status and renal function when clinically indicated (label/clinical).

Interactions

Delayed gastric emptying can affect absorption of some oral medications during titration; review narrow-therapeutic-index agents and time-sensitive regimens (clinical).
Hypoglycemia risk increases when used with insulin or sulfonylureas in patients with diabetes; coordinate dose adjustments with the diabetes prescriber (label/clinical).

Other Useful Information

In psychiatric care, ensure weight-management goals do not destabilize the treatment plan. Focus on sustaining adherence, monitoring for dehydration, and coordinating medication changes across prescribers (clinical).

References

WEGOVY (semaglutide) injection prescribing information — DailyMed (2026)
Once Weekly Semaglutide IN Adults With Overweight OR Obesity — New England Journal of Medicine (2021)
Effect OF Liraglutide Treatment ON Prediabetes AND Overweight OR Obesity IN Clozapine OR Olanzapine Treated Patients With Schizophrenia Spectrum Disorder: A Randomized Clinical Trial — JAMA Psychiatry (2017)
Therapeutic Management OF Atypical Antipsychotic Related Metabolic Dysfunctions Using GLP 1 Receptor Agonists: A Systematic Review — Experimental and Therapeutic Medicine (2023)