Semaglutide does not appear to increase the risk of suicidal ideation compared with non-glucagon-like peptide 1 receptor agonist (GLP-1RA) medications for obesity and diabetes, according to a retrospective cohort study funded by the National Institutes of Health (NIH).

Given the concerns over case reports of suicidal ideation tied to semaglutide, researchers from Case Western University and the National Institute on Drug Abuse sought to examine whether an association existed between the GLP-1RA and suicidal ideation. They examined electronic health records (EHRs) in the US from 240,618 overweight or obese patients prescribed anti-obesity medications between June 2021 and December 2022; 7847 of these patients had a history of suicidal ideation. Similarly, they reviewed EHRs for 1,589,855 patients with type 2 diabetes (T2D) who were prescribed semaglutide or another diabetes medication between December 2017 and May 2021; this group included 16,970 patients with a history of suicidal ideation. Medical histories were tracked for 6 months after the patients were prescribed the medication.

Findings showed that in the overweight/obese patient population, the risk of first time suicidal ideation among those treated with semaglutide was 0.11% compared with 0.43% with other weight loss medications. Among patients with a prior history of suicidal ideation, the risk of recurrent suicidal ideation was 7% with semaglutide and 14% with other obesity drugs.

In the T2D population, semaglutide was associated with a 0.13% risk of first time suicidal ideation compared with 0.36% for other diabetes medications. In those with a prior history, the risk of recurrent suicidal ideation was 10% for semaglutide and 18% for other diabetes medications. With longer follow-up (up to 3 years), the risk of first time suicidal ideation in T2D patients was also found to be lower compared with other medications.

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“Our findings do not support higher risks of suicidal ideation with semaglutide compared with non-GLP1R agonist anti-obesity or anti-diabetes medications,” the authors concluded. They suggested additional studies be conducted to evaluate the potential long term associations between semaglutide and suicidal ideation or suicide attempt.

In a recent quarterly report, the Food and Drug Administration (FDA) stated it would be investigating new side effects reported with GLP-1 RA use including hair loss, aspiration, and suicidal ideation. 

This article originally appeared on MPR

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