A retrospective observational study was conducted in the United States to evaluate the risk of suicidal ideation in patients treated with semaglutide medications, such as Ozempic® and Wegovy®. Semaglutide is a GLP-1 agonist that is effective in controlling blood sugar levels as well as appetite. Ozempic® is indicated for the treatment of type 2 diabetes, and Wegovy® is indicated for obesity. Since 2010, the FDA has received 265 reports of suicidal thoughts or behavior in patients taking semaglutide or similar medications, with 36 of these resulting in death. Based on this, suicidal ideation has been listed as a potential safety concern worth further investigation for GLP-1 agonists by the FDA.
The researchers reviewed 240,258 patients taking Wegovy® or other weight loss medications and approximately 1.6 million patients taking Ozempic® or other type 2 diabetes medications. During the first 6 months, reports of first-time suicidal ideation were seen in 0.11% of Wegovy® patients versus 0.43% of patients who were taking other prescription weight loss drugs. The risk of first-time suicidal ideation was 73% lower in the Wegovy® group, and the risk of recurrent suicidal thoughts was 56% lower than other weight loss medications. There were no suicide attempts seen in the Wegovy® group, but 14 users of other weight loss drugs reported a suicide attempt. Ozempic®, when compared with other type 2 diabetes medications, showed a similar pattern to Wegovy®. Findings were consistent across sex, age, or ethnicity.
A key limitation to interpreting the findings of this study was the retrospective use of existing data. Researchers could not customize the data collected for specific measures and had to rely on the information provided in electronic health records. This may have led to underreported suicidal ideation as it is likely that not all patients were asked about this during routine clinical visits. Consequentially, this study cannot definitively prove that GLP-1 agonists do not increase the risk of suicidal thoughts. Further research is warranted, using clinical trials designed to collect and analyze specific measures of suicidal thoughts and behaviors in patients prescribed a GLP-1 agonist medication.