Why bother going to work? If I didn’t work, I wouldn’t get paid, so there was that. But it seemed like a pointless exercise. I would stare at my monitor until it was time to go home. On some level I knew I should be, well, working, but I couldn’t collect my scattered thoughts enough to do it. I was also manic. Not the fun kind of mania where everything’s a great adventure, and all ideas are brilliant, but the kind where I’m crawling with anxiety and can’t sit still.
How did I get here? Everything was fine until two weeks ago. I do have ADHD and bipolar disorder, but I’ve been medicated for years. I work, I take care of my household, I pay taxes. Now I thought I might have to go on FMLA for an indefinite period. Or maybe even disability.
I finally did what I should have done two weeks ago and called my psychiatrist. I hate calling my psychiatrist. He’s actually a great guy, but after all these years, I should be able to handle this myself. After all, I was diagnosed with Type II diabetes, too, and apart from the initial adjustment period, I was doing just fine. Decent blood sugar numbers, some spikes. We were on our third round of trying to find a medication combination that both worked and didn’t kill me with nausea, but I was optimistic.
At the same time, I got a text message from a friend who knew I was having issues: “Hey, have you heard that semaglutide can interfere with the absorption of ADHD meds? Some anecdotal evidence. You might check it out.”
That was exactly what was happening. Not just the ADHD meds but the mood stabilizer, the antidepressant, the antianxiety meds, and everything else, too. I was taking Rybelsus, a semaglutide variant available in pill form. And it had apparently stopped my body from absorbing a bunch of other medications that I really needed.
As my psychiatrist told me, one doesn’t stop taking psychiatric meds. One tapers down, often over weeks. And you would never stop taking more than one at a time. That would be crazy (if you’ll pardon the expression). Taking Rybelsus was like hitting the brakes at 90 mph with no seat belt. No wonder my brain was a scrambled egg.
The growing popularity of Ozempic and its variants for weight loss means a lot of people who are taking other medications may end up taking them. 11 percent of Americans, for example, take antidepressants. The target population for Ozempic, people with obesity, are more than twice as likely to be taking antidepressants as other Americans. (In a chicken and egg situation, antidepressants are also notorious for causing weight gain.) 16.5 percent of Americans took prescription medication for a mental health issue in 2020. Those numbers have probably not gone down since the pandemic. Plenty of older people also take statins, blood pressure medications, and heart medications.
I did not, in fact, get fired. I was able to take a week off to work part-time from home while I transitioned to another diabetes medication. The Rybelsus took five to six weeks to leave my system. During that time, things gradually got better. I am still cleaning up the mess and will be for months to come.
I’m amazed how few people seem to know about this potential problem. It doesn’t happen to everybody, but if you Google “Ozempic pregnancies,” about women whose birth control medication just–stopped working, you’ll see that it does happen. Yes, there is a warning in the prescriber’s instructions (one sentence: “Rybelsus causes a delay of gastric emptying, and thereby has the potential to impact the absorption of other oral medications.” I’m sure most doctors are much more worried about patients’ family history of thyroid and pancreatic cancers, though. In any case, I was not warned. Even if I were, I doubt I would have known what to look for until it was already happening.
So I’m trying to tell as many people as possible. I keep thinking about someone with schizophrenia, well-medicated and functional in day-to-day life, who suddenly starts hallucinating again. Or people medicated for depression getting worse and becoming suicidal without warning. Thanks for listening. And please tell people.
Jennifer Jonsson is a patient advocate.
