GLP-1s Don't Increase Suicide Risk

Medscape

a day ago

It's not uncommon for me, when discussing a GLP-1 medication with patients, to have them inquire about the drug's purported risk in increasing suicidal ideation. What has never occurred? Patients asking about the possible benefits of GLP-1 medications to mood and to their decreasing the risk of suicidal ideation.
On the face of existing data, that's odd considering there is far more substantial evidence that GLP-1 users see improvements in mood: with no increase —and possibly decreased — risk of suicide. It's not odd, though, when considering things through the lens of how risk is overestimated by the public along with the lens of weight bias where, at least with obesity medications, negative findings — however small, tenuous, or early — tend to be readily internalized and amplified, while positive findings are often minimized and ignored.
Where and how did the concern about suicide arise? On July 11, 2023, the European Medicines Agency (EMA) released a statement that, consequent to the Icelandic medicines agency's highlighting three case reports involving suicide among GLP-1 users, they would be investigating further.
The EMA's statement rightly and explicitly noted, ' The presence of a signal does not necessarily mean that a medicine caused the adverse event in question .'
But much of the media didn't seem to care how premature or unsubstantiated the putative risk, and this story definitely had legs gaining scary coverage in most major media outlets. By way of example, the BBC, in its story headlined Weight-loss jabs investigated for suicide risk , rather than responsibly covering the prematurity of concluding anything at all, chose this quote from the EMA's statement to highlight, ' A signal is information on a new or known adverse event that is potentially caused by a medicine and that warrants further investigation .' No doubt this sort of reporting is in part why, to this day, patients still recount suicidality as a concern when discussing these medications.
But what has happened on this file since the July 2023 initiated investigation of those three purported cases? While nonexhaustive, here's a brief rundown:
In April 2024, the EMA's own investigation exonerated GLP-1 medications as a source of increased suicide risk in April 2024.
The US FDA also conducted its own investigation and similarly found no ties between GLP-1s and suicide risk.
In June 2024. a paper was published demonstrating no increase risk in suicidality among 36,083 adults prescribed GLP-1 medications.
In August 2024, a paper was published investigating GLP-1 medications and their impact on 22 neurological and psychiatric outcomes over 12 months. It found no impact among 23,386 GLP-1 users.
In September 2024, a paper was published demonstrating no increased risk in suicidality among a cohort of 124,517 adults prescribed GLP-1 medications over a 1-year period.
In October 2024, a paper was published demonstrating a 33% reduction in suicide ideation or attempts among 6912 adolescents with obesity for those who initiated treatment with GLP-1s over 3 years of follow-up.
In February 2025. a paper was published of a nationwide (France) case-time-control of individuals who had attempted or died by suicide which found no linkage with GLP-1 use.
In May 2025. a paper was published demonstrating in a meta-analysis of doubly blind randomized controlled trials that, among the 107,000 patients studied, GLP-1 use was not associated with increased risk of psychiatric adverse events or worsening depressive symptoms relative to placebo. Instead, GLP-1 use was associated with improvements in both physical and mental health-related quality of life.
Finally, in June 2025, a paper was published describing a multinational self-controlled case series analysis of suicide or self-harm attempts in Hong Kong, Taiwan, and the United Kingdom that yes, again, demonstrated no increased risk among GLP-1 users and that, compared with the nontreatment period, lower suicide attempt or self-harm risk following GLP-1 treatment was observed, especially after longer periods of treatment.
Negative publication bias appears to extend beyond academia into society at large. However, it manifests somewhat differently. The studies receiving the most attention are often those reporting literally negative (ie, adverse) outcomes. In contrast, more rigorous studies that challenge these negative findings, even if publicized, rarely achieve comparable societal penetration or awareness.