Is there a link between GLP-1s and suicidality?

An analysis found that the use of semaglutide, a glucagon-like peptide-1 receptor agonist, may be linked to increased suicidal ideation, particularly in conjunction with antidepressants, according to a study published Aug. 20 in JAMA Network Open; however, not all experts are convinced.

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The study analyzed data from VigiBase, the World Health Organization’s database compiling  adverse event reports associated with medicines and vaccines, for reports of suicidal thinking in patients taking Ozempic and Wegovy, which are two forms of semaglutide developed by Novo Nordisk for the treatment of diabetes and weight loss, respectively. Reports of suicidal ideation and behaviors as side effects related to semaglutide occurred 45% more than in other treatments for weight loss and diabetes, with the highest reports among patients taking antidepressants alongside semaglutide.

However, the FDA said a preliminary study conducted early this year did not find evidence that use of drugs like Ozempic and Wegovy causes suicidal thoughts or actions, but that it cannot be ruled out and the agency is continuing to investigate, Bloomberg reported Aug. 20. In April, the European Medicines Agency, which evaluates the pharmaceutical industry, also found no added risk of suicide or self-harm for people taking the drugs.

Novo Nordisk said its clinical trials also did not find a risk, but it will work with regulators to monitor the safety of the medicines, the drugmaker said in a statement to Bloomburg. 

“[The JAMA analysis] has major limitations,” Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said in a statement, adding that reports from patients like those in the WHO database “are very subject to bias, including effects of media reporting.”

Ozempic, Wegovy and other GLP-1s have been under scrutiny in the medical community, with some studies indicating the drugs may be linked to certain eye conditions that can cause vision loss, increased surgical risks and other detrimental effects. However, other studies have found  a possible link to decreased rates of dementia and reduced severity of liver disease in people with HIV.

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