Mood Swings / Emotional Lability / Irritability / Agitation / Anger
Users on Reddit report a variety of experiences regarding mood changes while on GLP-1 medications, including mood swings, emotional lability, irritability, agitation, and anger. While some users experience negative mood effects, others report mood improvements. The experiences can be influenced by dosage, the specific type of GLP-1 medication, pre-existing conditions, and individual physiological responses.
Experiences with Mood Swings / Emotional Lability / Irritability / Agitation / Anger:
Another user on Wegovy reported a similar pattern: "I have often had a day or occasionally two or depression right after my shot. "[2]
Clinicians have observed significant mood shifts. A psychiatrist reported, "It caused one of my patients with Bipolar Disorder to have a mixed episode (features of mania and depression) and caused suicidality, leading to psychiatric hospitalization. "[3] The symptoms reportedly started about one week after the patient's PCP started them on Ozempic, with no other changes. [4]
Another clinician described a severe case: "Semaglutide —> 70 lbs weight loss —> sky rocketing tremors on prior stable valproate —> mania emerges as dose is reduced —> tries to attack me because they believe I’m hacking their devices etc etc. "[5]
One user mentioned that the medication "suppresses emotions a bit," which could contribute to a sense of emotional change. [6]
Another user stated, "This medication made my anxiety and irritability extremely terrible. "[8]
A clinician anecdotally reported, "one rage issue actually (one guy screamed at the MA and it was very unlike him). "[9]
Feelings of agitation or being "revved up" were described by a psychologist taking tirzepatide: "this med is pretty activating for me. I have more energy overall and also physical symptoms of anxiety during the 2-3 days following each shot. I feel “revved up”, a little shaky... "[10]
One user on Liraglutide experienced "serious anxiety problems," and on Semaglutide had "mild anxiety. "[11]
Another user reported "debilitating anxiety and insomnia" on a GLP-1 medication. [12]
A clinician stated, "I’ve definitely had patients who have had to stop GLP-1 because of its effect on mood... In my practice, 20%ish had noticed some negative change in mood. "[13] These patients primarily had MDD or BPAD and were on SSRIs or SGAs. [14]
Another clinician mentioned, "Anecdotally, I’ve had a few patients who stopped these medications secondary to anhedonia/depressed mood. "[15]
A user taking Tirzepatide shared, "Tirzepatide made me incredibly depressed at first but those effects diminished over time and I ended up happier. "[16]
The impact on the brain's reward system is a hypothesized cause: "These meds are reducing reward seeking behavior... I could see how in some people, the seeking behavior could be turned down so much that it becomes anhedonia or depression. "[17] Another user echoed this, saying mood issues might be related to "a loss of joy from dopamine (for many, food was the go to for this and it doesn’t do it anymore). "[18]
Drug-Specific Differences: Some anecdotal observations suggest a difference between medications: "Patients who feel better are on tirzepatide/Mounjaro and those who feel worse are on semaglutide/Ozempic. "[20]
Pre-existing Conditions: Mood changes can be more pronounced or complicated in individuals with pre-existing psychiatric conditions like Bipolar Disorder or depression. [1, 3, 8, 13, 14]
Potential Mechanisms: Theories include alteration of dopaminergic transmission,[21, 18, 17] malnutrition (B vitamins, electrolytes),[18] or effects on the absorption of other psychiatric medications due to delayed gastric emptying. [22]
Remedies and Preventions Recommended:
Nutritional Supplementation:
Ensuring adequate nutrition, particularly B vitamins and electrolytes, is suggested. "Daily supplementation with a good B Complex and electrolytes can do wonders. Many folks perk up right away with this change. "[18]
Awareness and Monitoring:
Clinicians often warn patients about the potential for mood changes. "I warn my patients ahead of time when they tell me they may be starting. "[13] Another said, "I warn all my patients about mood changes when starting or increasing GLP1s. "[19]
Time / Allowing for Adjustment:
For some individuals, negative mood effects may lessen or resolve over time as their body adjusts to the medication. "Tirzepatide made me incredibly depressed at first but those effects diminished over time and I ended up happier. "[16] Another user noted that for some, "these side effects are tolerable or decrease over time. "[17]
Discontinuation:
In some cases, discontinuing the medication is necessary if mood side effects are severe or intolerable. [13, 15, 17]
It's highlighted that experiences are very individual, and what one person experiences, another may not. Open communication with a healthcare provider is crucial when starting or taking GLP-1 medications.
Experiences with Mood Swings / Emotional Lability / Irritability / Agitation / Anger:
- Mood Swings & Emotional Lability:
- Some users describe experiencing fluctuating moods, such as depression that appears and resolves.
- Irritability / Agitation / Anger:
- Increased irritability is a reported side effect.
- General Worsening of Mood / Depression / Anhedonia:
- Some users and clinicians report instances of new or worsened depression and anhedonia (loss of joy).
- Contextual Factors:
- Timing and Dosage: Mood changes can occur shortly after starting the medication or increasing the dose.
- Positive Mood Effects for Some:
Remedies and Preventions Recommended:
- Dosage Adjustment:
- Lowering the dose is a common recommendation if mood changes occur.
It's highlighted that experiences are very individual, and what one person experiences, another may not. Open communication with a healthcare provider is crucial when starting or taking GLP-1 medications.