2025-2026 GLP-1 RA Updates:

• Liraglutide:
  • Dose: 3.0 mg QD (6% A1c reduction), 1.8 mg QD (4.7% A1c reduction)
  • Side effects: Gastrointestinal (nausea, vomiting, diarrhea, reflux), hypoglycemia (with insulin/sulfonylurea), contraindicated in MTC/MEN2
• Tirzepatide (Dual GIP/GLP-1 RA):
  • Dose: 15 mg weekly (14.7% A1c reduction), 10 mg weekly (12.8% A1c reduction)
  • Side effects: Nausea (11–40%), vomiting (4–13%), diarrhea (9–17%)
  • Rationale: Dual agonism enhances glucose control; GI side effects remain primary concern.

• Depression Considerations:
  • GLP-1 RAs may have neuroprotective effects, but depression is not a formal indication.
  • Rationale: Limited evidence; monitor for mood changes in elderly patients.