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About The Study: In this disproportionality study of an adverse drug reaction database, researchers identified a disproportionality signal of suicidal ideation with semaglutide, but not for liraglutide, particularly among patients with co-reported antidepressant use, a proxy for affective disorders (a notable exclusion criteria of premarketing clinical trials). A detected signal of semaglutide-associated suicidal ideation warrants urgent clarification.
Expert Reaction
These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.
Margaret Morris is a Professor of Pharmacology at the University of New South Wales
The study used a WHO global data base of suspected adverse drug reactions (ADR) to look at people being treated with semaglutide or liraglutide who reported an ADR. Reasons for treatment include weight management, diabetes as well as off label use.
It reports a small increase in suicidal ideation with semaglutide, but not liraglutide. The authors comment that trials of GLP 1 receptor agonist drugs in obesity had exclusion criteria for mental health disorders, so reports from such trials may be less precise in capturing the risk of suicidal ideation. There are a number of limitations to the study – including adjusting for potential confounders such as alcohol and substance misuse, off label use of the drug, lack of information on dose used, and time to the ADR.
Dr Trevor Steward is Senior Research Fellow in the School of Psychological Sciences at the University of Melbourne
This analysis of a World Health Organization database suggests that people taking antidepressants may be more likely to report suicidal ideation when taking semaglutide (also known as Ozempic and Wegovy). The study raises key questions about whether additional precautions are needed when prescribing semaglutide to patients with mental health issues and if warnings about the increased risk of suicidal thoughts for some people should be included on the medication's labels. The findings also suggest that people with diabetes or obesity who don’t have mental health conditions might not be at high risk of experiencing suicidal thoughts while taking semaglutide, but more studies are needed to confirm this.
The rise in off-label prescribing of these medications is concerning, and there is an urgent need for larger studies to understand any potential risks related to both the patient and the medication itself. Major factors to consider include the patient's specific motivations for using the medication, any history of mental health issues, and sociodemographic issues. Given that these medications have become so popular, this study should be seen as a wake-up call on the importance of supporting larger studies that aim to understand how these medications may impact the brain, who they are safe for, and who might be at risk.
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