Table of Contents
Introduction
Semaglutide is a medication that has gained attention in recent years. It is used to treat type 2 diabetes and obesity. Many people have started using it because it helps lower blood sugar and leads to weight loss. Some of the common brand names for semaglutide include Ozempic, Wegovy, and Rybelsus. Doctors have been prescribing it to more people as the number of cases of obesity and diabetes continues to rise.
Semaglutide works by copying a hormone in the body called GLP-1 (glucagon-like peptide-1). This hormone helps control blood sugar and makes people feel full after eating. Because of how it works, semaglutide can help people eat less and lose weight. It also helps keep blood sugar at healthier levels. Many studies have shown that semaglutide is effective in helping people reach these goals.
Even though semaglutide helps with physical health, there have been some concerns about how it might affect mental health. Some people have wondered whether it might cause changes in mood or thoughts. There have even been reports of people experiencing depression or suicidal thoughts while using the drug. These concerns have led to questions about whether semaglutide could be linked to suicidal thoughts or behavior.
This is a serious issue. Suicidal thoughts can be dangerous and may lead to harm if not addressed. When new drugs become popular, health agencies often keep a close watch on any reports of side effects. In 2023, the European Medicines Agency (EMA) began looking into these reports. They wanted to find out if there was a real connection between semaglutide and suicidal thoughts. The United States Food and Drug Administration (FDA) also monitors the safety of semaglutide through its reporting systems.
It is important to understand that just because someone reports a side effect does not mean the drug caused it. Many people who take semaglutide already have health conditions like obesity or diabetes. These conditions are sometimes linked with mental health challenges, including depression and anxiety. Some people also take other medications at the same time, which can make it hard to tell what is causing a problem. That’s why scientists and doctors need to study large numbers of patients over time to see if there is a real pattern.
Understanding whether semaglutide is linked to suicidal thoughts is not simple. It involves looking at reports from doctors and patients, clinical trial results, and long-term data. Health officials also look at how often these events happen in people taking semaglutide compared to those not taking the drug. They want to know if there is a higher rate of suicidal thoughts among users or if the risk is the same as in the general population.
The goal of this article is to explore the available information about semaglutide and suicidal thoughts. It looks at what clinical studies say, what health agencies like the EMA and FDA have found, and what scientists believe based on current research. This article also answers common questions that people have asked online. These include whether semaglutide can cause mood changes, how often these side effects are reported, and what people should do if they are worried about their mental health while using the drug.
No opinions or personal stories are included in this article. Instead, it focuses on the facts and what is known from scientific research and public health data. By looking at the evidence, this article hopes to give a clear picture of what is known so far and what is still being studied. The issue of mental health and medication is important, and having accurate information can help people make better decisions about their care.
As semaglutide continues to be used by more people, it is important to stay informed about both its benefits and its risks. That includes knowing how it might affect not just the body, but also the mind.
What Is Semaglutide and How Does It Work?
Semaglutide is a medication used to treat type 2 diabetes and to help people lose weight. It is part of a group of drugs called GLP-1 receptor agonists, or glucagon-like peptide-1 receptor agonists. These drugs copy the actions of a natural hormone in the body called GLP-1. This hormone plays a key role in blood sugar control, appetite, and digestion.
Semaglutide helps the body manage blood sugar levels and can also lead to weight loss. It does this by affecting how the pancreas, brain, and stomach work during and after eating. Doctors often prescribe semaglutide to people who have type 2 diabetes or obesity when diet and exercise alone are not enough.
Brand Names and How It’s Taken
Semaglutide is sold under several brand names. The most common are:
- Ozempic – used for treating type 2 diabetes
- Wegovy – approved for chronic weight management
- Rybelsus – an oral (pill) form used for diabetes
Ozempic and Wegovy are taken by injection, usually once a week. Rybelsus is taken as a tablet, once a day, on an empty stomach.
Although the name may change depending on the purpose—diabetes or weight loss—the drug inside is the same. The dose, however, may be different. For example, weight-loss doses are generally higher than those used for diabetes treatment.
How Semaglutide Works in the Body
Semaglutide works by mimicking GLP-1, a hormone that the gut naturally releases after eating. This hormone has several effects:
- Increases Insulin Release:
When blood sugar levels rise after a meal, semaglutide helps the pancreas release more insulin. Insulin is the hormone that moves sugar from the blood into the cells for energy. - Reduces Glucagon:
Glucagon is a hormone that raises blood sugar. Semaglutide lowers glucagon levels, which helps keep blood sugar under control. - Slows Stomach Emptying:
Semaglutide slows how fast food leaves the stomach. This makes people feel full longer and may reduce how much they eat. - Acts on the Brain:
The drug also affects brain areas involved in appetite and hunger. This leads to a reduced desire to eat and can support weight loss.
These effects help both people with diabetes (by improving blood sugar control) and those with obesity (by helping them lose weight).
Common Side Effects
Most people tolerate semaglutide well, but some side effects are common. The most reported ones include:
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Stomach pain
These side effects are usually mild and go away over time. They often occur when starting the medicine or when increasing the dose.
Some people also notice reduced appetite or changes in taste. These are expected effects and often part of the drug’s role in weight loss.
Less Common but Serious Side Effects
Though rare, semaglutide has been linked to some serious side effects. These may include:
- Pancreatitis (inflammation of the pancreas)
- Gallbladder problems (such as gallstones)
- Kidney problems
- Allergic reactions
There have also been questions about possible links to thyroid tumors, based on animal studies. However, this has not been proven in humans.
Patients with certain health problems—like a history of pancreatitis or medullary thyroid cancer—are usually not prescribed semaglutide.
Why It’s Popular
Semaglutide has become one of the most widely used drugs for weight management and type 2 diabetes in recent years. Studies show that it leads to more weight loss than older medications. It also helps control blood sugar better than many other diabetes drugs.
Because of these strong results, many doctors now use semaglutide as a first-line treatment. The weekly injection schedule is also convenient, which makes it easier for patients to stick with the treatment.
Semaglutide is a medication that helps lower blood sugar and support weight loss by acting like the natural hormone GLP-1. It slows digestion, reduces hunger, and helps the pancreas release insulin. It is sold under different brand names depending on its use, and comes in both injectable and pill forms. While it is effective and often well-tolerated, it can cause side effects, most of which are mild. Understanding how semaglutide works helps explain both its benefits and why some people are concerned about possible mental health effects, which will be explored in later sections.
What Are the Mental Health Side Effects Listed for Semaglutide?
Semaglutide is a medicine used to help people lower their blood sugar or lose weight. It is sold under brand names like Ozempic, Wegovy, and Rybelsus. Like all medicines, semaglutide can cause side effects. Most of these are physical, such as nausea, vomiting, or stomach pain. However, some people are concerned about possible effects on mental health, such as mood changes, anxiety, depression, or suicidal thoughts.
The official drug labels from health authorities list the known side effects of semaglutide. These labels are made based on data from research studies and reported problems after the medicine is used by the public.
What the Drug Labels Say
In the United States, the Food and Drug Administration (FDA) approves drug labels. The labels for Ozempic and Wegovy include many details about side effects. As of now, they do not include suicidal thoughts or behavior as a confirmed side effect. However, the label for Wegovy—the version of semaglutide used for weight management—does carry a warning to monitor for depression and suicidal thoughts. This is similar to a warning found on many other weight-loss medications.
The Wegovy label says that people should be watched for changes in mood or behavior, especially if they have a history of mental illness. It also recommends stopping the drug if a person develops suicidal thoughts or behaviors.
The label for Ozempic, which is used to treat Type 2 diabetes, does not include the same warning. This may be because the patients in the Ozempic studies had different health issues and were not using the drug for weight loss. The Rybelsus label is also similar to Ozempic and does not include a strong warning about suicidal thoughts.
Reports from Clinical Trials
When semaglutide was tested in clinical trials, researchers recorded all side effects, including any mental health issues. These trials involved thousands of patients. The results showed that most people did not report serious mental health changes. However, a small number of people reported depression, anxiety, or suicidal thoughts. The number of cases was low and similar to what would be expected in the general population.
In trials for Wegovy, a few people reported suicidal thoughts. These cases led the company and regulators to add a caution on the drug’s label. Still, the total number of reports was not high enough to prove that semaglutide was the cause.
What Is the Difference Between Known and Suspected Side Effects?
A known side effect is something that has been clearly linked to a medicine based on strong evidence. A suspected side effect is something that may be related, but more research is needed to be sure.
In the case of semaglutide, suicidal thoughts are considered a suspected side effect, especially for Wegovy. There is not enough proof to confirm that semaglutide directly causes these thoughts. But because the issue is serious, health agencies recommend caution. This is why the warning appears on the label, even if the evidence is not yet strong.
How Are These Warnings Decided?
When a drug is approved, the company gives all the trial data to regulators like the FDA in the U.S. or the European Medicines Agency (EMA) in Europe. These agencies decide which side effects to include on the label. If new side effects are reported after approval, the label can be updated.
For semaglutide, the warnings about mental health are based on a mix of trial data, reports from doctors and patients, and known risks of weight-loss drugs in general.
Semaglutide’s labels list mostly physical side effects, but Wegovy includes a warning about depression and suicidal thoughts. This warning is based on a few reports and the known risks of weight-loss drugs. So far, the link between semaglutide and mental health changes is not proven, but it is being watched closely. Doctors are advised to monitor patients, especially those with a history of depression or anxiety, and to stop the medicine if suicidal thoughts occur.
Have Any Studies Shown a Link Between Semaglutide and Suicidal Thoughts?
Semaglutide is a medicine often used for type 2 diabetes and weight loss. It works by helping the body control blood sugar and reduce appetite. While many people benefit from this medicine, there have been questions about whether it might affect mental health, especially by causing suicidal thoughts. This concern has led scientists and health agencies to look more closely at research studies, clinical trials, and safety reports.
What Clinical Trials Have Shown
Before any medicine is approved, it must go through large clinical trials. These trials test the medicine on thousands of people to see how safe and effective it is. For semaglutide, several major trial programs were conducted, including STEP, SUSTAIN, and PIONEER. These trials looked at semaglutide in people with obesity or type 2 diabetes.
Across these trials, suicidal thoughts or behaviors were reported in very small numbers. In fact, most studies did not show any clear pattern suggesting that semaglutide causes suicidal thinking. For example, in the STEP trials, which focused on weight loss, a few participants reported mood changes, but the number of suicidal thoughts was not higher than what is normally seen in people trying to lose weight or people with obesity.
Some participants did report feelings of depression or anxiety. However, these symptoms were also seen in participants taking placebo (a dummy pill with no medicine). This makes it hard to know whether the symptoms were caused by the medicine or by other factors, such as stress, weight changes, or personal life issues.
What Post-Marketing Reports Show
After a medicine is approved, it continues to be monitored through post-marketing surveillance. This includes systems like the U.S. FDA’s MedWatch and the European Union’s EudraVigilance. These systems collect reports from doctors, patients, and drug companies about side effects that happen in real life, outside of clinical trials.
Some of these reports have included cases of suicidal thoughts in people taking semaglutide. These reports do not prove that the medicine caused the thoughts. Often, these individuals also had other health problems like depression or anxiety. They may have also been taking other medications at the same time.
Even though these reports do not show clear proof, they are still important. If a pattern is seen in many reports, it can prompt health agencies to take a closer look. That is what happened in 2023 when the European Medicines Agency began to review whether semaglutide and similar medicines might be linked to suicidal thoughts.
Studies Focused on Psychiatric Effects
A few studies have tried to look more closely at how semaglutide affects the brain and mood. Some animal studies have shown that GLP-1 receptor agonists (the class of drugs that includes semaglutide) can affect brain areas involved in mood and behavior. However, results in animals do not always apply to people.
A 2022 study published in a medical journal looked at psychiatric side effects across several GLP-1 medicines. The researchers found no strong evidence linking semaglutide to increased suicide risk. However, they did recommend that doctors be cautious in patients who already have a history of mental health conditions.
Other researchers have pointed out that weight loss itself can affect mood—both in good and bad ways. For example, losing weight may improve self-esteem, but it may also change body chemistry or lead to emotional stress. This makes it harder to know if semaglutide is directly responsible for any mood changes or if the changes come from other factors.
So far, large-scale studies and trial data do not confirm that semaglutide causes suicidal thoughts. However, because of the seriousness of mental health symptoms, health agencies continue to monitor these possible side effects. New studies may help answer remaining questions, especially in people with a history of depression or anxiety.
Doctors are encouraged to talk with patients about any changes in mood while taking semaglutide. If a person has a history of mental health problems, extra care and regular check-ins may help reduce risks and ensure safe treatment.
Why Did the European Medicines Agency (EMA) Investigate Suicidal Risk with GLP-1 Drugs?
The European Medicines Agency (EMA) started a safety review of semaglutide and similar drugs in July 2023. The review began after reports suggested that some people taking these medications may have experienced suicidal thoughts or behaviors. These drugs belong to a group called GLP-1 receptor agonists. They are mainly used to help control blood sugar in people with type 2 diabetes. Some versions are also approved to help with weight loss in people with obesity or other weight-related health problems.
Health agencies like the EMA take reports of possible side effects very seriously, especially when they involve mental health. Even if only a few cases are reported, they may still be important. The EMA decided to look closely at whether there might be a real link between these drugs and suicidal thoughts or self-harm.
What Led to the Investigation?
The safety review began because of reports from Iceland’s Medicines Agency. These reports came from patients who said they experienced thoughts of self-harm or suicide while taking semaglutide (brand names like Ozempic and Wegovy). The number of reports was small, but because the possible side effect was serious, the EMA launched a formal investigation.
The EMA did not only look at semaglutide. It included other GLP-1 drugs like liraglutide (Saxenda), dulaglutide (Trulicity), and exenatide (Byetta). These medications work in similar ways and are used for similar health conditions.
The EMA review looked at both clinical trial data and real-world reports. Clinical trials are studies that are done before and after a drug is approved to check how safe and effective it is. Real-world reports come from people who take the drug in their daily lives and share any problems they experience with their doctors or directly with the authorities.
What Did the EMA Look For?
During the review, experts at the EMA searched for reports of:
- Suicidal thoughts
- Suicide attempts
- Self-harming behavior
- Depression or other mood-related problems
They reviewed medical records and looked at patterns to see if these side effects happened more often in people taking GLP-1 drugs than in the general population or in people taking other kinds of medications.
The agency also asked the companies that make the drugs to provide all available safety data. This included any new information from clinical trials, post-marketing studies, and patient reports.
What Did the EMA Find?
As of late 2023, the EMA said that there was no clear evidence that GLP-1 drugs, including semaglutide, directly caused suicidal thoughts or behaviors. The number of reported cases was still very low compared to how many people take the medication. Millions of people use these drugs every year.
However, the EMA also stated that more information was needed. The agency said it would continue to monitor these reports and might update its advice if stronger evidence appears. Even though no official changes were made to the drug labels at that time, the EMA reminded doctors to watch for any signs of mental health issues in patients using these drugs.
What Were the Limits of the EMA’s Review?
One major challenge is that suicidal thoughts can be caused by many different things. People who take semaglutide often already have serious health conditions, such as obesity, type 2 diabetes, or depression. These conditions themselves can raise the risk of suicidal thoughts. Because of this, it can be very hard to tell if the medication is causing the problem or if it is related to the person’s overall health.
Also, not all people who experience side effects report them. Some cases may go unnoticed. On the other hand, some side effects that are reported may not be related to the drug at all.
What Happens Next?
The EMA is continuing to collect safety data on semaglutide and other GLP-1 receptor agonists. If new evidence shows a stronger link between these drugs and mental health problems, the agency may require drug companies to update their warnings or change how the medications are prescribed. For now, the EMA advises healthcare providers to talk to patients about possible side effects and to follow up on any signs of depression or suicidal thinking.
The EMA’s review shows how important safety monitoring is, even after a drug is approved. It also shows the need for more research into how these drugs may affect the brain, mood, and behavior. Even though a clear connection has not been proven, ongoing studies and reports will help make sure these medications are safe for all who use them.
What Has the FDA Said About Semaglutide and Suicide Risk?
The U.S. Food and Drug Administration (FDA) is the federal agency responsible for reviewing and approving the safety of medications in the United States. This includes reviewing data from clinical trials and reports of side effects once a drug is on the market. For semaglutide, the FDA has not found strong enough evidence to require a warning for suicide risk on the label. However, the agency continues to monitor new information closely.
Current FDA Labeling for Semaglutide
Semaglutide is approved by the FDA under several brand names, including Ozempic, Wegovy, and Rybelsus. Each of these products has official labeling, also known as a “prescribing information” sheet. This label lists all known and potential side effects, based on clinical trial data and other scientific findings.
As of now, none of the FDA-approved semaglutide products carry a black box warning for suicidal thoughts or behaviors. A black box warning is the most serious type of warning the FDA can add to a drug label. It is used when there is strong evidence of a serious risk, such as suicide, liver failure, or heart damage.
However, Wegovy, which is approved for weight loss, includes a precaution about suicide-related thoughts. The label says that patients should be monitored for new or worsening depression, suicidal thoughts, or unusual changes in mood or behavior. This warning does not appear in the labels for Ozempic (approved for diabetes) or Rybelsus (oral semaglutide).
The warning in Wegovy’s label is not based on strong proof that semaglutide causes suicidal thoughts. Instead, it is based on similar warnings in other weight loss medications. These warnings are often added when a medication affects the central nervous system or appetite, because such changes can sometimes be linked to mood changes in certain people.
FDA’s Review of Neuropsychiatric Risks
The FDA routinely reviews data from many sources to detect possible safety issues. These sources include:
- Clinical trials: These are carefully controlled studies done before a drug is approved.
- Post-marketing reports: After a drug is approved, doctors and patients can report side effects to the FDA through a system called MedWatch.
- Scientific literature: The FDA also looks at published research studies and case reports.
At the time of approval, semaglutide clinical trials did not show a clear increase in suicidal thoughts compared to people taking a placebo (a sugar pill). In most trials, suicidal thoughts were rare or not reported at all. However, the number of people in these studies was limited, and most were not being treated for mental health conditions.
After semaglutide was approved and widely used, some people began reporting mood changes, including depression and suicidal thoughts. These reports were sent to MedWatch. But these reports do not prove that semaglutide caused the symptoms. Other factors—such as stress, weight-related stigma, personal mental health history, or other medications—could also be involved.
Because of these concerns, the FDA continues to monitor semaglutide through its pharmacovigilance systems. This means the agency is keeping track of any new reports that may suggest a pattern or risk. If the FDA finds new evidence of danger, it can update the drug label, issue a warning, or even limit how the drug is prescribed.
Comparing FDA Actions to Other Medications
Some drugs that affect weight or the brain do carry stronger warnings. For example:
- Contrave (a weight loss drug containing bupropion and naltrexone) carries a black box warning about suicidal thoughts.
- Antidepressants like fluoxetine (Prozac) have black box warnings for increased risk of suicidal thoughts in children and young adults.
Semaglutide is not in the same category as these drugs. It works on blood sugar and appetite by mimicking a gut hormone, not by acting directly on brain chemicals like serotonin or dopamine. Still, because it may influence the brain indirectly, the FDA is being cautious.
Ongoing Monitoring and Public Health Importance
Even though no clear link has been proven, the FDA encourages patients and healthcare providers to report any serious mental health changes while using semaglutide. These reports help regulators watch for trends that might not appear in clinical trials.
The FDA may work with other health agencies around the world, such as the European Medicines Agency (EMA), to share findings and compare safety data. This collaboration helps identify rare but serious risks more quickly.
The FDA has not found enough evidence to say semaglutide causes suicidal thoughts or behaviors. Still, the agency advises caution, especially for people with a history of depression or mood disorders. The FDA continues to watch closely for any new signs of risk and will take action if needed.
How Common Are Suicidal Thoughts Among People Taking Semaglutide?
Semaglutide is a medication that helps lower blood sugar and support weight loss. It is approved for people with type 2 diabetes and for those with obesity or overweight who have other health problems. Like all medicines, semaglutide can cause side effects. One rare but serious concern is whether semaglutide is linked to suicidal thoughts.
Suicidal thoughts, also called suicidal ideation, refer to thinking about or planning suicide. These thoughts can be mild or severe. In some people, they may pass quickly. In others, they may lead to dangerous actions. Because semaglutide works through hormones and affects the brain as well as the body, researchers are paying close attention to this possible risk.
Adverse Event Reports
Reports of suicidal thoughts or behaviors linked to semaglutide have been found in post-marketing data. These reports come from patients, doctors, and healthcare workers after a drug is already approved and in use. For example, the U.S. Food and Drug Administration (FDA) tracks these events through a system called FAERS (FDA Adverse Event Reporting System). In Europe, the system is called EudraVigilance.
It is important to understand that a report does not prove a drug caused the problem. Many factors may be involved, including the person’s health history, other medications, or life events. Some people taking semaglutide already have a higher risk for depression or anxiety due to obesity, diabetes, or other medical conditions. So, when someone reports suicidal thoughts while on semaglutide, it may not be clear whether the drug played a role or not.
Still, safety agencies take these reports seriously. In 2023, the European Medicines Agency (EMA) began reviewing hundreds of such cases involving semaglutide and similar drugs to check for any patterns. Most cases were rare and often lacked clear medical details. No definite link has been found so far, but the review is ongoing.
Clinical Trial Data
Clinical trials are research studies that test drugs before they are approved. These trials help scientists learn about a drug’s effects and safety. In trials for semaglutide, suicidal thoughts were not commonly reported. For example, in the large STEP and SUSTAIN studies, researchers tracked both physical and mental health. They did not find higher rates of suicidal thinking in people taking semaglutide compared to those taking a placebo (a pill with no medicine).
However, clinical trials may not catch rare side effects. Trials often have fewer people than the number who will eventually take the drug once it is on the market. Also, people with serious mental health problems are often excluded from trials. That means the data may not fully reflect what happens in the general population.
Background Risk in the General Population
It is also helpful to compare the rate of suicidal thoughts in people taking semaglutide to the general risk in people with similar health conditions. For example, people living with obesity or type 2 diabetes are more likely to experience depression and anxiety. Studies show that having a chronic illness can raise the risk of suicidal thoughts.
One study found that about 10% to 15% of people with obesity may have had suicidal thoughts at some point. In people with diabetes, the rate is also higher than in the general population. If a person with one of these conditions starts semaglutide and later reports suicidal thoughts, the medicine may not be the cause. It could be related to their underlying health, emotional state, or other stressors.
Caution in Interpreting Data
Even when suicidal thoughts are reported in people using semaglutide, there is no clear evidence that the drug causes these thoughts directly. Suicidal ideation is complex and can be triggered by many different things. Medicines that affect appetite, hormones, or the brain can sometimes influence mood. However, scientists need strong evidence before saying a medicine causes a specific mental health problem.
At this time, there is no proof that suicidal thoughts are common among semaglutide users. The number of reports is very low compared to the millions of people who have taken the drug. Still, healthcare providers are advised to be careful. It is important to monitor patients who may already have mental health concerns and to take any mood changes seriously.
Understanding the true risk takes time, large studies, and careful analysis. Research is ongoing, and both the FDA and EMA continue to review new data as it becomes available.
Can Semaglutide Affect Mood, Anxiety, or Depression?
Some people have asked whether semaglutide might affect mood, cause anxiety, or lead to symptoms of depression. While semaglutide is mostly known for helping people lose weight or manage type 2 diabetes, questions about mental health side effects have become more common. These questions are important because mood changes and mental health symptoms can affect quality of life and treatment decisions.
Reports of Mood Changes
Some patients who have taken semaglutide have reported changes in mood. These reports include feeling sad, anxious, or restless. Some people also said they felt emotionally flat or lost interest in things they usually enjoyed. These kinds of changes are also symptoms of depression.
Although these experiences have been reported, they are not confirmed to be caused by semaglutide. Mood changes can happen for many reasons, including stress, medical conditions, or other medicines. In some cases, the changes may be related to the person’s health before starting semaglutide.
What Clinical Studies Show
Large clinical trials for semaglutide were mostly designed to study weight loss or blood sugar control, not mental health. As a result, these trials did not always include detailed mental health assessments. In most trials, serious mood problems were rare. Depression, anxiety, and suicidal thoughts were reported by only a small number of participants, and at similar rates as those taking a placebo (a pill with no active drug).
However, it is possible that smaller mood changes were missed, or not reported. Clinical trials often follow strict rules, and participants may not report every symptom. Also, people with a history of serious mental illness are sometimes not allowed to take part in these studies. This makes it harder to know how semaglutide affects people with depression or anxiety.
How Semaglutide Might Affect the Brain
Semaglutide belongs to a group of drugs called GLP-1 receptor agonists. These drugs work by copying the effect of a natural hormone in the body called GLP-1 (glucagon-like peptide-1). This hormone helps control appetite, blood sugar, and digestion.
GLP-1 receptors are not only found in the gut and pancreas. They are also found in the brain. Because semaglutide can cross into the brain, it may affect brain areas that control hunger, emotion, and reward. Scientists are still learning how this works, but this is one reason why researchers are studying whether semaglutide can cause changes in mood.
Some studies in animals suggest that GLP-1 receptor agonists might influence the brain’s reward system, which is involved in mood and motivation. This system uses chemicals like dopamine and serotonin. These are the same brain chemicals involved in depression and anxiety. However, animal studies do not always predict how a drug will affect people.
Effects of Weight Loss on Mood
For many people, weight loss can improve mood and self-esteem. Losing weight may reduce inflammation, improve sleep, and increase energy, all of which can have positive effects on mental health. This means that people taking semaglutide might feel better simply because they are losing weight and becoming healthier.
However, weight loss can also lead to emotional changes. Some people feel pressure to maintain weight loss or worry about gaining it back. In rare cases, rapid weight loss might cause low energy or hormonal changes that affect mood. It is also important to remember that weight loss does not always lead to improved body image or mental health in everyone.
Need for More Research
Right now, there is not enough evidence to say for sure if semaglutide causes mood changes in some people. Most research so far shows no strong link. Still, more studies are needed to understand how semaglutide might affect the brain and mood, especially over a long period.
Doctors and researchers are watching for signs of depression, anxiety, or other mental health issues in people taking semaglutide. Anyone who notices a change in mood while taking this medication should talk to a healthcare provider. Tracking and reporting these symptoms helps improve the safety of the drug for everyone.
Understanding how semaglutide affects mood is complex. Many factors, including brain chemistry, physical health, past mental health history, and life changes, can play a role. While no clear link has been proven, the topic deserves continued attention and research.
Are Certain People at Higher Risk for Psychiatric Side Effects on Semaglutide?
Semaglutide is a medication used to help people with type 2 diabetes or obesity. It helps lower blood sugar and support weight loss. Like all medications, semaglutide may cause side effects. Most of these are related to the stomach, such as nausea or vomiting. However, some people are concerned about mental health side effects, including depression or suicidal thoughts. While there is no clear proof that semaglutide causes these problems, some people may be more likely to experience them than others.
People With a History of Mental Health Disorders
One of the most important risk factors is a past history of mental health conditions. People who have been diagnosed with depression, anxiety, bipolar disorder, or schizophrenia may be more sensitive to mood changes while taking any new medication. This includes semaglutide.
A person with a history of suicidal thoughts or suicide attempts may also be more at risk. Even if they have not had symptoms for a long time, a new medication could possibly trigger old feelings. This does not mean everyone with mental health issues will have a problem with semaglutide. But extra care is often needed when starting the drug.
Doctors may check in more often or suggest that patients also work with a mental health provider while taking semaglutide. People with a known history of depression or suicidal thoughts should make sure their prescriber is aware of this history.
People Taking Other Psychiatric Medications
Some medications that treat mental health conditions can interact with semaglutide. This does not always mean a dangerous drug interaction in the body, but it may affect how the person feels emotionally. For example, some antidepressants or mood stabilizers can take time to adjust in the brain. Adding a medication like semaglutide at the same time might make it harder to know what is causing any new mood symptoms.
People taking multiple medications, especially for depression, anxiety, or attention-deficit/hyperactivity disorder (ADHD), should talk to their doctor about possible side effects. Doctors may suggest starting semaglutide at a lower dose or monitoring mood changes more closely in these cases.
People With Chronic Medical Conditions
Living with a chronic illness, such as diabetes or obesity, already increases the risk of mental health problems. Research has shown that people with diabetes are more likely to feel depressed than people without diabetes. Obesity is also linked to anxiety and low self-esteem in some people.
When someone starts a drug like semaglutide, which brings big changes to the body and appetite, it can sometimes affect how they feel mentally. For example, rapid weight loss or changes in eating habits might cause emotional stress for people who have struggled with body image or eating disorders in the past.
Doctors may need to watch for mood shifts, especially in patients who have struggled emotionally while managing their health. These shifts may not be caused directly by semaglutide, but by the larger process of adjusting to treatment and physical changes.
Older Adults and Teenagers
Age can also play a role. Some studies show that teenagers and young adults are more likely to experience emotional side effects with certain medications. Their brains are still developing, and mood disorders often first appear during these years. While semaglutide is not approved for most people under age 18, some off-label use may occur.
In older adults, mental health problems can sometimes be harder to detect. A change in mood, energy, or interest in daily activities might be mistaken for aging. If a person starts semaglutide and seems more withdrawn or less interested in things they used to enjoy, a family member or caregiver may need to speak with the doctor.
People With Limited Support Systems
Social support can also make a difference. People who live alone, have little family support, or are under a lot of stress may have a harder time managing emotional changes. A strong support system can help someone notice symptoms early and seek help if needed. Without this support, mood changes might go unnoticed and grow more serious over time.
Why Identifying Risk Matters
Knowing who might be more likely to have mental health side effects can help prevent serious problems. Doctors can take steps to screen patients before starting semaglutide. They may ask questions about mental health history, sleep, mood, and stress levels. If concerns are found, doctors might work with other healthcare providers to build a treatment plan that includes mental health care.
In some cases, patients may still take semaglutide but be watched more closely. Catching mood changes early often leads to better outcomes. It is also important for patients and families to understand what signs to watch for and to speak up if something does not feel right.
What Should Patients Do If They Experience Mood Changes or Suicidal Thoughts While Taking Semaglutide?
Semaglutide is a medication used to help people with type 2 diabetes and obesity manage their blood sugar and weight. While most people taking semaglutide do not report serious mental health problems, some have experienced mood changes, including sadness, anxiety, or thoughts of self-harm. These symptoms are not common, but they are important to recognize and take seriously.
Recognizing Warning Signs
Mental health side effects can appear in different ways. Some signs may be easy to miss at first. Changes may be slow or sudden. Some of the common warning signs to watch for include:
- Feeling sad, empty, or hopeless most of the time
- Losing interest in favorite activities
- Feeling very anxious, tense, or restless
- Changes in sleep patterns, such as trouble sleeping or sleeping too much
- Changes in eating habits, such as eating too little or too much
- Withdrawing from friends and family
- Talking about feeling worthless or guilty
- Expressing thoughts about death, dying, or suicide
- Sudden mood swings or strong emotional reactions
Even if these changes seem small or temporary, they should not be ignored. It is better to talk about them early, before they become worse.
When to Contact a Healthcare Provider
Any new or unusual mood symptoms should be reported to a doctor, nurse, or pharmacist right away. If a person taking semaglutide starts having thoughts of harming themselves or feels overwhelmed, they should seek help as soon as possible.
A healthcare provider can assess the situation and decide what steps to take. In some cases, they may recommend stopping semaglutide. In other cases, they may suggest speaking with a mental health professional. It is important to be open and honest about how someone is feeling. Mental health is just as important as physical health.
In emergency situations—such as someone actively thinking about suicide—immediate help is needed. This can mean calling emergency services, going to a hospital, or contacting a crisis hotline.
Importance of Monitoring and Communication
Doctors who prescribe semaglutide may ask about mental health history before starting treatment. This helps them understand the full picture of a patient’s health. People with a personal or family history of depression, bipolar disorder, or past suicidal thoughts may need closer monitoring while using semaglutide.
Regular follow-up visits give healthcare providers a chance to ask about mood changes, emotional well-being, and other symptoms. Patients should feel encouraged to report any mental health concerns, even if they seem small or unrelated to the medication.
Loved ones and caregivers can also play a role. They may notice changes in behavior, speech, or mood that the person taking semaglutide may not recognize right away. Caregivers should speak up if they see signs of distress or unusual behavior.
Deciding Whether to Continue or Stop Semaglutide
If mood problems appear while taking semaglutide, doctors may need to weigh the risks and benefits. Stopping the medication suddenly is not always the right answer. In some cases, the symptoms may be linked to other issues such as stress, other medications, or medical conditions.
Doctors may decide to reduce the dose, switch to a different medication, or refer the patient for mental health support. Each case is different, and decisions should be made with careful thought.
Stopping semaglutide without medical advice is not recommended. A sudden stop may affect blood sugar levels or weight, which could lead to other health issues. Any changes to treatment should always be made under a doctor’s supervision.
Building a Support System
Having a strong support system can help people manage both physical and emotional health while on semaglutide. Support may come from family, friends, therapists, or support groups. Talking about feelings and getting help early can prevent serious problems.
Healthy lifestyle choices can also support mental health. Getting regular exercise, eating balanced meals, sleeping well, and staying socially connected all make a difference.
How Is Ongoing Safety of Semaglutide Monitored After Approval?
Once a medicine like semaglutide is approved and used by the public, safety monitoring does not stop. Even though clinical trials provide useful information about how well a drug works and what side effects may happen, some rare or long-term side effects may only appear after many people start using the drug in real life. This is why ongoing safety monitoring is an important part of drug regulation. It helps protect patients and allows health agencies to take action if new risks are found.
What Is Pharmacovigilance?
Pharmacovigilance is the process of tracking and studying the safety of medicines after they have been approved for public use. Drug companies, healthcare professionals, and government agencies all play a role in this system. The main goal is to identify and respond to any unexpected problems that might be linked to a drug, including side effects that are serious, long-term, or rare.
Pharmacovigilance is especially important for new medicines or for drugs that are being used in large numbers of people, such as semaglutide. Since semaglutide is prescribed for common conditions like obesity and type 2 diabetes, millions of people worldwide may be taking it. This makes careful monitoring essential to detect problems that might not have shown up during clinical trials.
What Systems Track Side Effects?
Several systems are used to collect and study reports of side effects and safety problems with drugs. In the United States, the FDA Adverse Event Reporting System (FAERS) is one of the main tools. In Europe, a similar system called EudraVigilance is run by the European Medicines Agency (EMA).
These systems allow doctors, pharmacists, patients, and drug companies to report any side effects that may be linked to a medicine. These side effects can be mild or serious. Some reports may describe physical symptoms like nausea or headache, while others may mention emotional or mental health concerns like depression or suicidal thoughts.
The reports are stored in large databases. Experts then analyze the data to look for patterns. If a medicine appears to be linked to more reports of a certain side effect than expected, this may raise a safety signal. A safety signal does not prove that the drug caused the problem, but it is a sign that more study is needed.
How Are Reports Investigated?
When a safety signal is detected, health authorities may begin a formal investigation. This can include reviewing more data from clinical trials, animal studies, and new patient reports. Sometimes, drug companies may be asked to provide additional safety data or to run new studies to explore the issue further.
If enough evidence is found, the drug’s label may be updated to include new warnings or side effects. In some cases, authorities may limit how the drug can be used or require special monitoring for certain groups of patients. In very rare cases, a drug may be withdrawn from the market.
For semaglutide, both the FDA and EMA are closely watching for reports of mental health changes, including suicidal thoughts. As of now, no clear proof has been found that semaglutide causes suicidal thoughts. However, the monitoring systems continue to collect and review all new reports. This allows health officials to act quickly if new evidence appears.
Why Reporting Matters
Reporting possible side effects is one of the most important ways to help improve drug safety. Even though not every report leads to a confirmed risk, each report adds to the full picture of how a drug affects people in real life. Patients who share their experiences—through healthcare providers or directly—help researchers and safety teams learn more about possible side effects that may not have been seen in studies.
Doctors and pharmacists are also encouraged to report side effects, especially serious ones. In some countries, healthcare professionals are required by law to report certain events. Drug companies also have to collect and report any side effects they learn about from patients, studies, or medical literature.
Keeping Patients Safe Over Time
Medicines like semaglutide stay under review long after they reach the market. Post-marketing safety efforts help make sure that any new risks are found as early as possible. If a pattern of concern appears—such as an increase in reports of suicidal thoughts—regulators may act to protect public health.
Ongoing safety monitoring is a shared responsibility. It depends on communication between patients, healthcare providers, drug companies, and government agencies. This system is designed to catch problems early and take steps to reduce harm, while still allowing patients to benefit from the medicine.
By carefully tracking real-world use and side effects, pharmacovigilance helps ensure that drugs like semaglutide remain both effective and as safe as possible over time.
Conclusion
Semaglutide is a medication used to treat type 2 diabetes and obesity. It works by helping the body lower blood sugar levels and reduce appetite. This medicine has become more popular in recent years because many people have lost weight while using it. However, as more people start using semaglutide, questions have come up about its safety. One of the biggest concerns is whether it may cause suicidal thoughts or other serious mental health problems.
Right now, there is no clear proof that semaglutide causes suicidal thoughts. Large clinical trials were done before the drug was approved. These trials looked for serious side effects, including changes in mood and mental health. So far, the studies have not shown a strong connection between semaglutide and suicide risk. Some people reported feeling depressed or anxious, but these problems were also seen in people who were not taking the medicine.
Even though there is no solid link, health agencies are still watching the situation closely. In 2023, the European Medicines Agency (EMA) started an investigation after receiving reports of suicidal thoughts in people taking semaglutide and other similar drugs. The agency looked at safety data and tried to find any patterns. They did not find enough evidence to say the drug caused the problem, but they have not ruled it out completely. They are continuing to collect and review reports.
In the United States, the Food and Drug Administration (FDA) has not added a warning about suicide to the label for semaglutide. The FDA requires drug companies to list known side effects in the product information. At this time, suicidal thoughts are not listed as a confirmed side effect. However, the FDA continues to monitor new safety reports through its MedWatch program and other systems. If strong evidence appears in the future, the FDA could update its guidance.
When people report suicidal thoughts while using a medication, it is important to look at the full picture. People with obesity or diabetes may already have a higher risk of depression or anxiety. Losing weight can also bring up many emotions. Some people feel happier, but others may struggle with body image, stress, or changes in routine. These factors can make it hard to tell if the drug is the cause or if something else is happening.
Doctors and researchers are also looking into how semaglutide affects the brain. GLP-1 receptor agonists like semaglutide work in the gut and the brain. Some parts of the brain help control appetite, mood, and thinking. Scientists are still learning how these medicines might influence those brain areas. While this raises important questions, no clear link has been proven between semaglutide and major mental health problems like suicidal thoughts.
Some people may be more likely to have mood changes while taking semaglutide. Those with a personal or family history of mental illness could be more sensitive to medications that affect the brain. That is why it is important for healthcare providers to ask about mental health history before starting treatment. Doctors should also check in with patients during treatment, especially if they notice mood swings, sadness, or thoughts of self-harm.
If someone taking semaglutide begins to feel depressed or starts having suicidal thoughts, it is important to seek help right away. Doctors can review the treatment plan and make changes if needed. This might include stopping the medicine or switching to a different treatment. In some cases, mental health care may also be helpful. Any serious change in mood should be taken seriously and treated with care.
Semaglutide is still being studied, even after its approval. Many safety checks happen after a drug is on the market. These include post-marketing studies and safety reports sent by patients, doctors, and pharmacists. These reports help drug agencies spot rare side effects that may not show up in early trials. If new risks are found, labels can be updated and warnings added to protect patients.
In summary, there is no proven link between semaglutide and suicidal thoughts, but the topic is still being studied. Health experts are taking the reports seriously and keeping track of new information. People who use semaglutide should be aware of possible side effects and talk to their doctors about any concerns. Careful monitoring, open communication, and more research will help make sure this medicine remains as safe and effective as possible.
Research Citations
Wang, W., Volkow, N. D., Berger, N. A., Davis, P. B., Kaelber, D. C., & Xu, R. (2024). Association of semaglutide with risk of suicidal ideation in a real‐world cohort. Nature Medicine, 30, 168–176. doi:10.1038/s41591-023-02672-2
Tobaiqy, M., & Elkout, H. (2024). Psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide: A pharmacovigilance analysis of individual case safety reports submitted to the EudraVigilance database. International Journal of Clinical Pharmacy, 46(2), 488–495. doi:10.1007/s11096-023-01694-7
Schoretsanitis, G., Weiler, S., Barbui, C., Raschi, E., & Gastaldon, C. (2024). Disproportionality analysis from World Health Organization data on semaglutide, liraglutide, and suicidality. JAMA Network Open, 7(8), e2423385. doi:10.1001/jamanetworkopen.2024.23385
Wadden, T. A., Brown, G. K., Egebjerg, C., Frenkel, O., Goldman, B., Kushner, R. F., McGowan, B., Overvad, M., & Fink-Jensen, A. (2024). Psychiatric safety of semaglutide for weight management in people without known major psychopathology: Post hoc analysis of the STEP 1, 2, 3, and 5 trials. JAMA Internal Medicine, 184(11), 1290–1300. doi:10.1001/jamainternmed.2024.4346
Julien, J., Malvy, S., Guérin, O., & Da Costa, A. (2024). Suicide and suicide attempt in users of GLP-1 receptor agonists: A nationwide case-time-control study. eClinicalMedicine, 100929. doi:10.1016/j.eclinm.2024.103029
McIntyre, R. S., Mansur, R. B., Rosenblat, J. D., & Kwan, A. T. H. (2024). The association between glucagon-like peptide-1 receptor agonists and suicidality: Reports to the Food and Drug Administration Adverse Event Reporting System (FAERS). Expert Opinion on Drug Safety, 23(1), 47–55. doi:10.1080/14740338.2023.2295397
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Mansur, R. B., Rosenblat, J. D., Brietzke, E., Goldstein, B. I., & McIntyre, R. S. (2025). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and suicidality: A replication study using reports to the World Health Organization pharmacovigilance database (VigiBase®). Journal of Affective Disorders, 369, 922–927. doi:10.1016/j.jad.2024.10.062
Questions and Answers: Semaglutide and Suicidal Thoughts
Semaglutide is a medication used to treat type 2 diabetes and obesity. It mimics a hormone called GLP-1 to help regulate blood sugar, reduce appetite, and promote weight loss.
There is no definitive evidence that semaglutide directly causes suicidal thoughts, but some reports have raised concerns, prompting regulatory agencies to monitor for such side effects.
In 2023, the FDA announced it was reviewing data on GLP-1 receptor agonists, including semaglutide, after receiving reports of suicidal ideation in some patients. No causal relationship has been confirmed.
Yes, some individuals have reported experiencing suicidal thoughts while taking semaglutide, but these cases are rare and not clearly proven to be caused by the drug.
As of mid-2024, suicidal ideation is not a standard listed side effect on the FDA label for semaglutide, but this may change depending on ongoing safety evaluations.
Patients with a history of depression or other mental health disorders should discuss the risks and benefits with their healthcare provider before starting semaglutide.
Stop the medication and seek immediate help from a healthcare provider or mental health professional. Suicidal thoughts should always be taken seriously.
Yes, the European Medicines Agency (EMA) began reviewing reports of suicidal thoughts and self-harm associated with GLP-1 drugs, including semaglutide, in 2023.
Some researchers speculate that dramatic weight loss or appetite changes might affect mood or mental state, but more studies are needed to determine a clear link.
If you notice mood changes, depression, or suicidal thoughts, you should contact your healthcare provider right away. Do not stop any prescription medication without medical guidance.
Dr. Melissa VanSickle
Dr. Melissa Vansickle, MD is a family medicine specialist in Onsted, MI and has over 24 years of experience in the medical field. She graduated from University of Michigan Medical School in 1998. She is affiliated with medical facilities Henry Ford Allegiance Health and Promedica Charles And Virginia Hickman Hospital. Her subspecialties include General Family Medicine, Urgent Care, Complementary and Integrative Medicine in Rural Health.