Examining GLP-1 Agonists and Potential Suicidal Ideation Risk

February 12, 2025

GLP-1 medications like Ozempic, Wegovy, and Saxenda have gained significant popularity for treating obesity and diabetes due to their proven efficacy. However, concerns have emerged regarding potential side effects, including suicidal thoughts.

In 2020, there were over 4 million prescriptions for Liraglutide and 9 million for Semaglutide, reflecting their widespread use. Reports of increased suicidal thoughts prompted scrutiny from regulatory agencies worldwide.

The Icelandic medicine agency raised concerns based on their data, leading the European medicine agency to investigate. In the United States, warnings about suicidal thoughts were present on the labels from the outset, influenced by past experiences with medications like Rimonabant, which was withdrawn due to similar risks.

GLP-1 Medications and Suicidal Thoughts

Multiple studies have been reviewed, yielding inconsistent findings. One study¹ examining reports to the FDA's adverse event system observed that Liraglutide (Saxenda) and Semaglutide (Wegovy) carried a higher risk of suicidal ideation. However, after accounting for confounding factors, no definitive association was found between GLP-1 medications and suicidal thoughts, depression, or suicide.

Surprisingly, a recent 2024 study² involving 240,618 patients with obesity and diabetes using Semaglutide found a lower risk of suicidal ideation compared to those using non-GLP-1 agonist medications for obesity or diabetes.

While this study suggests an association rather than causation, it underscores the importance of discussing risks and benefits with healthcare providers, considering individual factors. It is essential to recognize the emotional toll of obesity, stigma, and the devastating impact associated with obesity and diabetes. When deciding on treatment options, a careful risk-benefit assessment is necessary, weighing the risks of untreated obesity or diabetes against the potential side effects of medication.

By staying informed and working closely with healthcare providers, individuals can make the best decisions for their health and well-being.

Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss. Dr. Katz currently practices at Dr. Leon Katz Medical Weight Loss Center.

References

Roger S. McIntyre, Rodrigo B. Mansur, Joshua D. Rosenblat & Angela T.H. Kwan (13 Dec 2023): The association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and suicidality: reports to the Food and Drug Administration Adverse Event Reporting System (FAERS), Expert Opinion on Drug Safety
Link to study: https://doi.org/10.1080/14740338.2023.2295397
Nat Med. 2024 January; 30(1): 168–176. doi:10.1038/s41591-023-02672-2. Association of semaglutide with the risk of suicidal ideation in a real-world cohort.
Link to study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034947/

ABOUT THE AUTHOR

Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss. He focuses on patients seeking alternatives to surgery and those needing care after bariatric procedures. Dr. Katz was recently the director of a major medical weight loss program. With extensive experience in establishing successful weight management programs, he now concentrates exclusively on non-surgical weight loss solutions. Dr. Katz is a Diplomate of the American Board of Obesity Medicine and Fellow of American College of Surgeons. Dr. Katz currently practices at Dr. Leon Katz Medical Weight Loss Center.