Suicidal Thoughts / Ideation / Behavior
Users on Reddit report a mixed range of experiences regarding suicidal thoughts, ideation, or behavior while on GLP-1 medications. Some users express concern about this potential side effect, while others report improvement in their mental health, and some studies are cited as showing a lower risk. There are also discussions about whether these mood changes are a direct effect of the medication or related to other factors like weight loss or pre-existing conditions.
Experiences with Suicidal Thoughts / Ideation / Behavior:
A psychiatrist shared an experience: "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. "[23] They later clarified, "The patient had been stable on Vraylar for over two years... Her PCP started her on Ozempic, and about one week later, mixed episode symptoms started. Nothing else changed. "[4]
Another medical professional reported, "We had a suicide attempt from a patient taking mounjaro, could be unrelated but no previous MH issues and they reported mood changes since starting it". [13]
The FDA label for Wegovy is mentioned as including a warning for suicidal ideation. [10, 11]
One user asked, "How do we reconcile this study with the known sideffects for GLP-1 drugs to increase suicidal ideation in some people? "[1]
Another user linked dramatic weight loss following weight loss surgery to a "4x higher risk of death by suicide" and hoped for more research for patients to weigh risks versus rewards. [2]
Some users question the direct causality, suggesting other factors might be at play. One user mentioned, "Bariatric surgery increases suicide risk even more than this, FYI. I suspect it’s the weight loss itself, society’s reaction to people when they lose weight, and navigating all the difficult feelings in how one is treated before vs after that leads to this. "[27]
A user taking GLP-1s for PCOS, not for weight loss, stated, "This medication made my anxiety and irritability extremely terrible. So, while I don't want to discount what folks are experiencing with regard to the weight loss contributing to the mental health issues, I know that mine is directly due to the medication and its adverse effects. "[29]
Contrasting Experiences and Perspectives:
Conversely, some users report mental health improvements*. One user with ADHD said their "suicidal ideation nearly disappeared on meds. Turns out, that emptiness I was trying to fill was just missing dopamine. "[30]
A study mentioned in one post title suggests, "Anti-obesity drugs (GLP-1) linked to a 33% lower risk of suicidal thoughts or attempts among young people (ages 12-18). "[1, 3, 5, 6, 7, 9, 14, 15, 16, 17, 18, 19, 20, 30, 31, 32]
One commenter noted, "I’ve never had a patient complain of mood on them, quite the opposite. Isn’t there evidence that obesity is correlated with treatment resistant depression, primarily believed to be linked to increased inflammatory state? "[28]
Potential Mechanisms and Contributing Factors:
The impact of GLP-1s on the absorption of other medications, including psych meds, was raised as a potential issue: "My theory was that it affected his psych med absorption. "[11]
One user theorized that the reduction in the ability to use food for coping could lead to emotional distress if alternative coping mechanisms aren't in place: "Taking a GLP1 removes my ability to use food to cope with my emotions... If I hadn’t been in therapy and had worked on developing healthier coping skills prior to GLP1s, I can see that I could have been more of an emotional mess after using them since I didn’t have any way to cope. "[33]
Remedies and Preventions Recommended:
Monitoring and Awareness: Patients should be informed about potential mood changes. "just tell them what to look out for so they can tell you. "[10] Another professional stated, "I warn all my patients about mood changes when starting or increasing GLP1s. "[11]
Therapy and Coping Skills: For individuals who use food to cope with emotions, therapy to develop healthier coping mechanisms is suggested, especially before or during GLP-1 treatment. [33]
Consideration of Pre-existing Conditions: It's important to consider pre-existing mental health conditions. One psychiatrist noted that negative mood side effects were primarily seen in patients with MDD or BPAD on SSRIs or SGAs. [25]
Switching Medications: If mood changes occur, switching to a different GLP-1 (e. g. , from semaglutide to tirzepatide, or vice-versa) might be an option, as some users report different mood effects with different drugs. [24] One user's doctor chose liraglutide because it leaves the system faster if side effects like depression occur. [34]
Addressing Malnutrition: One user suggested that mood issues could be related to malnutrition, specifically B vitamins and electrolytes, due to decreased intake and dehydration.
Experiences with Suicidal Thoughts / Ideation / Behavior:
- Some users report experiencing suicidal thoughts or worsening depression while on GLP-1s.
Contrasting Experiences and Perspectives:
Conversely, some users report mental health improvements*. One user with ADHD said their "suicidal ideation nearly disappeared on meds. Turns out, that emptiness I was trying to fill was just missing dopamine. "[30]
- Another user with AuDHD taking Mounjaro reported, "The first DAY I did my intro injection of 2.
Potential Mechanisms and Contributing Factors:
- Some users and medical professionals speculate on the mechanisms.
Remedies and Preventions Recommended:
- Dosage Adjustment: A medical professional mentioned, "Anecdotally I notice mood changes at the higher dosages but if someone on Ozempic/Wegovy 1 mg starts getting depressed I drop them down to 0.