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Association of GLP-1 Receptor Agonists With Risk of Suicidal Ideation and Behaviour: A Systematic Review and
Ganesh Bushi1, Mahalaqua Nazli Khatib2, Shivam Rohilla3,4
1School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India.
Diabetes/Metabolism Research and Reviews
|February 13, 2025
Summary
This study found no significant link between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and increased suicidal ideation or behavior. However, further research is needed to confirm long-term neuropsychiatric safety.
Area of Science:
- Pharmacology
- Neuroscience
- Endocrinology
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are crucial for managing type 2 diabetes and obesity, offering metabolic and cardiovascular benefits.
- Emerging concerns regarding potential neuropsychiatric side effects, including suicidal ideation and behavior, necessitate thorough investigation.
Purpose of the Study:
- To systematically review and meta-analyze the association between GLP-1RA use and the risk of suicidal ideation or behavior.
- To evaluate the current evidence on the neuropsychiatric safety profile of GLP-1RAs.
Main Methods:
- A comprehensive systematic literature search was performed across PubMed, Embase, and Web of Science up to September 2024, following PRISMA guidelines.
- Included studies were observational cohort and case-control designs involving adults using GLP-1RAs, with risk of bias assessed using the Modified Newcastle-Ottawa Scale.
- Random-effect models were employed to calculate risk ratios (RR) with 95% confidence intervals (CIs), and heterogeneity was quantified using the I² statistic.
Main Results:
- The meta-analysis of four studies revealed no statistically significant difference in suicidal outcomes between GLP-1RA users and users of other anti-hyperglycemic drugs (RR: 0.568, 95% CI: 0.077-4.205).
- Significant heterogeneity was observed (I² = 98%), indicating variability across studies.
- Pharmacovigilance data did not show a disproportionate increase in suicidality, and some observational studies suggested a potentially lower risk.
Conclusions:
- The current systematic review and meta-analysis found no significant association between GLP-1RA use and an increased risk of suicidal ideation or behavior.
- High heterogeneity and reliance on pharmacovigilance data warrant caution and suggest the need for continued monitoring.
- Further research is essential to comprehensively assess the long-term neuropsychiatric safety of GLP-1RAs, especially in patients with pre-existing psychiatric conditions.
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