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Weight Loss Drugs Not Associated With Increased Suicidal Thoughts, Study Finds

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A new Nature Medicine study suggests that diabetes and weight loss drugs containing semaglutide are not associated with an increase in suicidal thoughts. Previous reports prompted the European Medicines Agency (EMA) to review the possibility they could increase risks of suicidal thoughts and self-injury.

Weighing in on weight loss drugs

Diabetes and weight loss drugs containing semaglutide – known as Ozempic® for diabetes and Wegovy™ for weight loss – work by mimicking the GLP-1 protein that is released in the gut after eating. This reduces appetite and helps regulate blood sugar.

These drugs have shown considerable success in clinical trials for weight loss, with patients in one trial losing nearly 15% of their body weight over 68 weeks alongside lifestyle changes.

Their potential benefits also extend to reducing heart disease risk, as well as potentially reducing symptoms of alcohol misuse disorder.

The Icelandic Medicines Agency triggered the EMA’s review after reports of suicidal thoughts and self-injury in those using semaglutide. A previous weight loss drug, rimonabant, was withdrawn in Europe in 2008 due to links to suicidal thoughts, and another – buproprion – comes with a boxed warning from the FDA notifying patients of similar risks.

The EMA’s review into semaglutide began in July 2023 and has since been extended to other GLP-1 agonists, with the authorities receiving approximately 150 reports of possible self-injury and suicidal thoughts.

Now, a new study from researchers at Case Western Reserve School of Medicine suggests that there is no evidence to support concerns over suicidal ideations with semaglutide.

No association with an increased risk of suicidal thoughts

The researchers examined data from nearly 2 million US patients taking semaglutide for type 2 diabetes or obesity.

The study participants were split into two groups – those using Ozempic and those using Wegovy – for analysis of their electronic health records over six months to track the occurrence of suicidal thoughts/ideations.

In the overall population, overweight or obese patients taking Wegovy were actually observed to have a 73% lower risk of suicidal ideations compared to those prescribed non-GLP-1 agonist anti-obesity drugs. They observed consistent reductions across gender, age and ethnicity sub-groups, and similar findings in the type 2 diabetes group that took Ozempic.

“Our findings do not support semaglutide having a higher risk of suicidal ideations compared with other anti-obesity or anti-diabetic medications,” the authors wrote in a linked research briefing. “Instead, semaglutide [was] associated with reduced risk of first-time suicidal ideations and relapse of suicidal ideations in patients with obesity (or who were overweight) and in patients with type 2 diabetes.”

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"The exploding popularity of this drug makes it imperative to understand all its potential complications," said Dr. Pamela B. Davis, one of the study’s authors and a professor at Case Western Reserve University, in a press release. "It's important to know that prior suggestions that the drug might trigger suicidal thoughts is not borne out in this very large and diverse population in the U.S."

“Future controlled trials are necessary to assess any causal relationships between semaglutide and other [GLP-1 receptor] agonist medications with suicidal ideations,” they added.

Reference: Wang W, Volkow ND, Berger NA, Davis PB, Kaelber DC, Xu R. Association of semaglutide with risk of suicidal ideation in a real-world cohort. Nat Med. 2024:1-9. doi: 10.1038/s41591-023-02672-2