Do GLP-1 Weight Loss and Diabetes Drugs Increase Suicide Risk? A Systematic Review of 22 Studies | Research

The takeaway

Adverse event reports flag semaglutide and liraglutide for increased suicidal ideation reports, but real-world cohort studies do not confirm a consistent increase in suicidality — and some suggest these drugs may actually reduce risk.

22 studies reviewed
This systematic review synthesized evidence from 10 pharmacovigilance studies and 12 cohort studies to assess whether GLP-1 receptor agonists are linked to suicidality — the largest such review to date on this question.

What the researchers found

This systematic review of 22 studies (10 pharmacovigilance, 12 cohort) found mixed results regarding GLP-1 receptor agonists and suicidality. Pharmacovigilance data showed disproportionate reporting of suicidal ideation for semaglutide and liraglutide specifically. However, cohort studies did not consistently show an increased risk of suicidality — and some GLP-1 RAs were actually associated with decreased suicidal ideation and suicide attempts. The authors concluded there is currently inadequate evidence to establish a causal link between GLP-1 RAs and suicidality.

Why it matters

With tens of millions of people now taking GLP-1 receptor agonists for diabetes and weight loss, understanding any potential psychiatric risks is critical. Reports to the FDA and EMA had raised alarm about possible links to suicidal thoughts, prompting this systematic review. The nuanced finding — that adverse event reports suggest a signal but real-world cohort data does not confirm it — helps clarify the actual risk landscape for prescribers and patients.

How the study worked

The researchers conducted a systematic review following PRISMA guidelines, searching seven databases (PubMed, Medline, Cochrane Library, PsychInfo, Embase, Scopus, and Web of Science) from inception through November 20, 2024, supplemented by manual Google Scholar searches. They included both pharmacovigilance studies (which analyze adverse event reports) and cohort studies (which follow patient populations over time). Cohort studies were assessed for quality using the Newcastle-Ottawa Scale. Suicidality was operationalized into three dimensions: suicidal ideation, suicide attempts, and suicide completion.

Who was studied

Patients prescribed GLP-1 receptor agonists, primarily for type 2 diabetes and obesity, across 22 pharmacovigilance and cohort studies

What this study cannot tell us

Pharmacovigilance data relies on voluntary adverse event reporting, which is subject to reporting bias — increased media attention on GLP-1 drugs may inflate reporting rates. The review could not establish causality. Patients prescribed GLP-1 RAs for obesity and diabetes already have higher baseline rates of mental illness, making it difficult to separate drug effects from underlying risk. The heterogeneity of study designs limits direct comparison across the 22 included studies.

How to read the evidence

This is a systematic review following PRISMA guidelines, which represents a high level of evidence synthesis. However, the included studies are observational (pharmacovigilance and cohort), not randomized controlled trials designed to assess suicidality. The inability to establish causality and heterogeneity across studies somewhat limits the strength of conclusions.

When this study was published

Published in 2025 with literature searched through November 2024, this is a very current review that captures the latest evidence on this rapidly evolving safety question.

The bigger picture

As GLP-1 receptor agonists become some of the most widely prescribed drugs in the world, any potential psychiatric side effects carry enormous public health implications. This review provides the most comprehensive assessment to date and lands on a reassuring but cautious conclusion: the signal in adverse event reports likely reflects reporting bias and confounding factors rather than a true drug-induced risk, but monitoring remains essential as more long-term data accumulates.

Questions still open

Is the disproportionate reporting of suicidal ideation for semaglutide and liraglutide driven by media-amplified reporting bias rather than a true pharmacological effect?
Do the neuropsychiatric effects differ meaningfully between specific GLP-1 receptor agonists, and could some actually be protective?
How should clinicians screen for suicide risk in the growing population of patients starting GLP-1 RA therapy for weight management?

Common questions

Should I be worried about suicidal thoughts if I'm taking Ozempic or a similar GLP-1 drug?

Based on this review, there is no confirmed causal link between GLP-1 drugs and increased suicidality. While adverse event reports show higher-than-expected mentions of suicidal ideation, studies that actually followed patients did not consistently find increased risk. However, as with any medication, you should report any new or worsening mood changes to your doctor.

Why do adverse event reports show a different picture than the cohort studies?

Adverse event databases collect voluntary reports, which can be heavily influenced by media coverage and public awareness. When news stories link a popular drug to suicide risk, more people and doctors report related symptoms, inflating the apparent signal. Cohort studies, which systematically track patients over time, provide a more controlled view and did not consistently confirm the risk.

Read the original research

The effect of glucagon-like Peptide-1 receptor agonists on measures of suicidality: A systematic review.

Journal of psychiatric research, 183, 112-126

View on PubMed ↗Publisher’s paper ↗

Citation

Valentino, Kyle; Teopiz, Kayla M; Cheung, William; Wong, Sabrina; Le, Gia Han; Rosenblat, Joshua D; Mansur, Rodrigo B; McIntyre, Roger S. (2025). The effect of glucagon-like Peptide-1 receptor agonists on measures of suicidality: A systematic review.. Journal of psychiatric research, 183, 112-126. https://doi.org/10.1016/j.jpsychires.2025.02.008