Ozempic, Wegovy Not Associated With Increased Risk of Suicidal Ideation, Study Finds

Fact checked by Nick Blackmer

• A new study found no association between semaglutide and increased suicidal thoughts.

• Actually, when compared to other drugs for type 2 diabetes and obesity treatments, semaglutide was associated with less risk of suicidal ideation.

• Experts recommend patients talk to a trusted healthcare professional before making any changes to the drugs they take.
  

There appears to be no association between Ozempic and increased suicidal thoughts, a new study finds.

The study comes at a time when semaglutide—the active ingredient in Ozempic and Wegovy—and other similar glucagon-like peptide 1 (GLP-1) agonist medications are under review.

In July of last year, the European Medicines Agency (EMA) made headlines for launching a review into GLP-1 medications over reports that some people taking the drug experienced an increased risk of suicidal ideation and thoughts of self-harm.

Additionally, in the U.S., the Food and Drug Administration (FDA) is currently “evaluating the need for regulatory action” against GLP-1 drugs over concerns of suicidal ideation, alopecia, and aspiration.

Wegovy does have depression or thoughts of suicide listed as a potential side effect on its label; Ozempic does not.

Amidst this increased concern, the new study, published last week in Nature Medicine, found that people taking semaglutide actually had a lower risk of suicidal ideation than people taking other drugs.

The study authors wrote that the results of the study “do not support the concerns of increased suicidal risk associated with semaglutide raised by the EMA.”

With the popularity of Ozempic, Wegovy, and similar medications, researchers are looking to find any potential side effects, as well as investigate the mechanisms behind type 2 diabetes, obesity, and mental health more generally.

This new study is important because it provides an “apples to apples” comparison between semaglutide and several different medications for type 2 diabetes and obesity, said Rekha Kumar, MD, MS, associate professor of clinical medicine in the division of endocrinology at Weill Cornell Medicine.

“What this shows us overall, is likely that people who have chronic disease such as obesity and diabetes, likely are more prone to suicidal ideation, [rather than] it being caused by the GLP-1 class of drugs,” Kumar told Health.

Related: Can Ozempic, Wegovy Cause Hair Loss and Suicidal Ideation? FDA Investigating GLP-1 Drug Side Effects

Comparing Ozempic, Wegovy Against Other Medications

After seeing the EMA’s report, the researchers were interested in investigating the potential connection between suicidal ideation and GLP-1 drugs, explained Rong Xu, PhD, one of the authors of the study and director of the Center for Artificial Intelligence in Drug Discovery at Case Western Reserve University.

“Because it’s case reports and suicidal ideation can happen for many different reasons—for underlying health conditions, other stress—and also because this drug is so popular, any evidence, robust evidence based on a big data [set], will help people really make decisions about the risk and the benefit of taking these medications,” Xu told Health.

The researchers used a large database of patient electronic health records, allowing them to see what was going on in real time.

The population consisted of two groups—about 240,000 patients who were prescribed either semaglutide or a non-GLP-1 anti-obesity medication and over 1.5 million patients with type 2 diabetes who were prescribed either semaglutide or a non-GLP-1 medication. None of the participants had any history of suicidal thoughts.

The type 2 diabetes category compared people taking semaglutide to people taking insulin, metformin, sulfonylureas, and four other anti-diabetes medications.

The semaglutide for weight loss participants were compared against people taking anti-obesity drugs bupropion, naltrexone, orlistat, topiramate, phentermine, and setmelanotide.

Within each group, the researchers looked for participants with “similar age, gender, race, socioeconomic status, and medical conditions,” so that they’d have a more even comparison.

“We found that people taking [semaglutide] have significantly lower risk for suicidal ideation compared to similar people taking weight loss drugs or anti-diabetes drugs,” said Xu.

These findings were consistent based on ethnicity, age, and gender.

Among people taking these medications who already had a history of suicidal ideation, researchers came to the same conclusion—people taking semaglutide were less likely to have recurrent suicidal ideation.

“Basically, we [get] a consistent result no matter how we look at the data,” Xu said.

Related: Menopausal Women May Benefit From Weight Loss Drugs Like Ozempic, Wegovy

Connection Between Weight Loss Drugs, Type 2 Diabetes Drugs, and Suicidal Ideation

According to Xu, the link between obesity and suicidal ideation has been an area of research for a while.

“Historically, other medicines that were approved for weight loss in the United States were pulled off the market because of concerns of suicidal ideation,” said Kumar. “Due to that history, the class of medicines GLP-1s that we’re talking about are being looked at more closely.”

Though this scrutiny is necessary to protect patients, Kumar believes these reports of suicidal ideation can be attributed to the condition—obesity or type 2 diabetes—rather than these medications.

“In this case, it’s not the GLP-1 effect, but rather the experience of living with a chronic disease that is more associated with suicidality versus the mechanism of the drug,” she said.

However, there’s still debate as to what the relationship between anti-obesity medications, obesity, and mental health looks like.

A 2022 study of young American adults found no association between obesity and suicidal ideation. In a 2023 article, those same researchers found that weight discrimination—often associated with obesity—is associated with suicidal ideation.

Though it seems to be less scrutinized, there is evidence that people with type 2 diabetes have a higher risk of depression and suicide.

More research is needed to fully explore how these chronic conditions may be deteriorating mental health, or if the medications for the conditions are contributing to mental decline.

As for why the study found that semaglutide was less likely to raise a person’s suicidal ideation risk as compared to other type 2 diabetes and obesity drugs, Xu said it’s unclear. Researchers speculated that it could have something to do with how semaglutide functions in the brain, though it’s an area for further study.

Due to the newness of semaglutide, more research is needed to understand how these drugs might affect suicidal ideation risk long-term, Xu said.

Related: How Do Ozempic, Mounjaro, Wegovy, and Zepbound Compare?

Managing Mental Health and Anti-Obesity, Anti-Diabetes Drugs

Xu explained that this research supports the idea that semaglutide may be a good option for people who experience suicidal ideation and need treatment for type 2 diabetes or obesity.

However, it’s too early to be making clinical recommendations, she clarified. Semaglutide may not work for everyone and has a host of separate side effects that could cause issues for certain people.

“Our data just provides another [source of] evidence so they can make informed decisions,” Xu said.

Ultimately, each person must talk to their doctor about the risks and benefits they might personally experience, rather than relying solely on data.

However, this research should be “reassurance” that in addition to being effective, semaglutide does seem to be safe, Kumar said.

People with mental health concerns shouldn’t necessarily avoid GLP-1 drugs if they could benefit from them. However, to take the medication safely, this group should keep their doctors informed of any issues so they can be properly monitored or referred to a mental health professional, said Kumar.

Related: Study: These Are the Most Effective Ways to Treat Obesity

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