GLP-1s Not Linked to Suicidal Thoughts, According to FDA
By April Hopcroft
The FDA is investigating reports of suicidal thoughts or actions in people taking diabetes and weight loss medications like Ozempic, Wegovy, and Mounjaro. Research is ongoing, but the analysis so far suggests GLP-1s do not cause suicidal thoughts or behavior.
The U.S. Food and Drug Administration (FDA) is investigating the association of GLP-1 receptor agonists, such as Ozempic and Mounjaro, with side effects including suicidal thoughts, hair loss, and airway obstructions.
In total, six Novo Nordisk products – including older diabetes medications Saxenda, Victoza, and Xultophy – were reported to potentially be linked with these unusual side effects.
The latest update from the FDA states there is no evidence that GLP-1s cause suicidal thoughts or actions, according to their preliminary analysis.
The National Institutes of Health (NIH) also recently announced results from a study of over 240,000 people with overweight or obesity who were prescribed weight loss medication. Research found that semaglutide was linked to a much lower risk of suicidal thoughts compared to non-GLP-1 weight loss medications.
After carefully reviewing clinical trials and reports submitted to the FDA’s Adverse Event Reporting System (FAERS), the FDA concluded that no available data showed a clear link between GLP-1 use and suicidal ideation or behavior. The FDA cited two key reasons for its determination:
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Limited information was provided in reports submitted to FAERS.
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Suicidal thoughts and actions can be affected by other factors beyond medication use.
However, the FDA is not ruling out that a risk of suicidal thoughts or actions may exist for people who take GLP-1s, and is therefore continuing its investigation.
Common side effects of GLP-1s
Many people who take incretin therapies like GLP-1s for diabetes management or weight loss experience gastrointestinal side effects. These typically include:
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Nausea or vomiting
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Diarrhea
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Decreased appetite
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Constipation
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Stomach pain
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Indigestion
Usually, any adverse reactions are most intense when first starting a medication or increasing the dose.
Serious side effects of these drugs include pancreatitis, hypoglycemia (low blood sugar), kidney failure, allergic reactions, thyroid tumors, and vision changes. Because incretins slow digestion, they can also affect the absorption of other medications, such as birth control pills.
Currently, the labels for Wegovy, Saxenda, and Zepbound list depression and suicidal thoughts as a possible serious side effect. The labels for Mounjaro, Ozempic, Rybelsus, and Victoza do not mention suicidal ideation and behavior.
Research finds lower rate of suicidal thoughts with semaglutide vs. other weight loss drugs
Separately, researchers from the NIH and Case Western Reserve University conducted a study investigating the link between weight loss medications and suicidal thoughts and behaviors among people with excess weight. Participants had a mean age of 50 years and the majority were female.
Overall, the study found that people taking semaglutide had a 49-73% lower risk of suicidal thoughts compared to people taking other weight loss medications. These findings were also replicated in over 1.5 million people with type 2 diabetes who were prescribed semaglutide or other diabetes medications.
Are there other concerns with GLP-1s?
With the growing popularity of Ozempic, Wegovy, and now Zepbound as “miracle” weight loss products, these drugs face several challenges.
First, there was the Ozempic shortage, forcing many people with diabetes to ration their doses or switch to other GLP-1s. Amid shortages of many GLP-1s, compounded versions of these medications cropped up. The FDA issued a warning on compounded semaglutide, explaining they do not review these medications for safety and efficacy, so they could be unsafe.
In October 2023, the FDA added a warning for intestinal blockages to Ozempic’s label following reports of this gastrointestinal complication.
The bottom line
All medications – even routine, over-the-counter products like cough syrup or Benadryl – carry side effects, some more unpleasant than others. The decision to take a new medication is a highly personal one based on the potential benefits and drawbacks, and should be made with your healthcare provider.
If you’re taking a GLP-1 for diabetes or weight management and you experience any unusual or bothersome side effects, consult with a healthcare provider.
If you are currently having suicidal thoughts and need immediate help, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or access the Crisis Text Line by texting “TALK” to 741741. Find additional helpful suicide prevention resources for people with diabetes here.
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