Ozempic and Wegovy: Rumours of higher suicidal thoughts with semaglutide dispelled by scientists

According the medical research being overweight or obese are not known risk factors for suicidal thoughts or indeed suicide itself.

Alarm bells were therefore raised when a 150 cases of suicidal ideations, a broad term used to describe a range of preoccupations with self-harm, death and suicide were reported to the  Icelandic medicines agency from men and women prescribed the new weight loss drugs semaglutide or liraglutide.

The use of semaglutide (Ozempic or Wegovy) and liraglutide (Saxenda) has exploded over the last two years, expanding so much that manufacturers can't keep up with demand, creating shortages and rationing. These drugs, known as GLP-1 receptor agonists involving a weekly injection, were initially licensed for obese individuals with diabetes or cardiac risk but can now be given for obesity alone.

Studies consistently show that both men and women taking these drugs, alongside other dietary and lifestyle measures, achieved over a 15 per cent weight loss even after only three to four months. They also reported improvements in measurements of heart risk and, most relevant to this latest research, psychological wellbeing.

These figure were impressive, considering that the best exercise programmes, even after a year were lucky to achieve a six per cent weight reduction.

Due to these findings, the publicity they attracted, and the high incidence of being overweight or obese (63% of the UK population), millions of people worldwide are now on these drugs. So, even if there is a small risk of suicide, in absolute terms, this would still be a significant number of people. It was therefore appropriate for the European Medicines Agency to initiate a formal review of the data and call for more research.

Fortunately, a team of scientists from the Centre for Science, Health, and Society at Case Western Reserve University School of Medicine in Cleveland, USA, took up the task. They conducted a massive study which was published on January 5, 2024 in the esteemed journal Nature Medicine. The researchers scrutinized the health records of 240,618 overweight or obesity patients who were prescribed semaglutide or other anti-obesity medications, plus a further 1.5 million patients with type two diabetes.

The researchers found that those prescribed semaglutide had a 0.11% risk of first-time suicidal ideations and 7% among people with a history of suicidal issues compared to 0.43% and 14%, respectively, for people prescribed other weight loss medications. In other words, the risk of suicidal thoughts were less than half in the semaglutide group, and this data was consistent across sex, age, and different ethnic groups.

This vigorous examination of such a large group of people by a prestigious medical organisation has provided robust and reliable evidence that semaglutide and other GLP1R agonists do not increase thoughts of self-harm and suicide. The conclusions of the researchers fell short of saying that these drugs could actually reduce the risk, even though the data supported it, until further confirmatory research is published - always a sensible statement for such a serious condition.