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Psychological and Psychiatric Consequences of Prolonged Fasting: A Narrative Synthesis of Neurobiological and Clinical Evidence

This narrative synthesis systematically examines peer-reviewed research on how prolonged and intermittent fasting affect mood, cognition, stress physiology, and psychiatric symptoms, covering both secular and religious fasting practices from 2010-2025. The review evaluates clinical trials and observational studies while critically assessing study quality and vulnerability factors, acknowledging that psychoneurobiological psychiatric consequences of fasting remain incompletely characterized despite documented metabolic benefits.

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This study measured blood MMP-9 levels in 186 depressed hospital patients (92 with recent suicide attempts, 94 without) and 79 non-psychiatric controls, finding significantly elevated MMP-9 in the recent attempt group compared to both other groups. Results suggest MMP-9 may be a biological marker associated with suicide risk in major depressive disorder.

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This systematic review evaluates the association between GLP-1 receptor agonists (medications used for diabetes and weight loss) and psychiatric manifestations including depression, suicidality, eating disorders, and substance use disorders. Evidence suggests modest antidepressant effects and potential therapeutic benefit in reward-regulation disorders, though concerns about suicidality remain unresolved and research is limited by small sample sizes and underrepresentation of people with psychiatric comorbidities.

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