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Impact of GLP-1 Receptor Agonists on Suicide Behavior: A Meta-Analysis Based on Randomized Controlled Trials

Jingqi Chen1, Qiufeng Zhang1, Qingping Wu1

  • 1The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.

Journal of Diabetes
|September 1, 2025
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show no significant association with suicidal behavior in patients with type 2 diabetes mellitus (T2DM) or obesity. This meta-analysis of 25 RCTs found no increased risk across various subgroups and GLP-1 RA types.

Area of Science:

  • Endocrinology
  • Psychiatry
  • Pharmacovigilance

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for managing type 2 diabetes mellitus (T2DM) and obesity.
  • Concerns have been raised regarding potential associations between GLP-1 RA use and suicidal behavior.
  • Robust evidence is needed to clarify this risk.

Purpose of the Study:

  • To conduct a meta-analysis assessing the association between GLP-1 RA exposure and suicidal behavior incidence.
  • To evaluate this association in patient populations with T2DM and/or obesity.

Main Methods:

  • A comprehensive literature search was performed across major electronic databases (PubMed, Web of Science, Cochrane Library, ClinicalTrials.gov).
  • Data from 25 randomized controlled trials (RCTs) were included.
  • Risk ratios (RR) and 95% confidence intervals (95% CI) were calculated to quantify the association.

Main Results:

  • The overall meta-analysis revealed no significant difference in suicidal behavior incidence between GLP-1 RA and control groups (RR = 0.84, 95% CI: 0.54-1.32, p = 0.46).
  • Subgroup analyses stratified by condition (T2DM, obesity), age (adolescents, adults), specific GLP-1 RAs, and comparator (placebo) also showed no significant associations.
  • No significant differences were observed for specific types of suicidal behavior, including ideation, attempts, depression-related suicides, and completed suicides.

Conclusions:

  • The findings suggest that GLP-1 RA use is not significantly associated with an increased risk of suicidal behavior in patients with T2DM or obesity.
  • The results provide reassurance regarding the safety profile of GLP-1 RAs concerning suicidal behavior.
Keywords:
GLP‐1 RAsmeta‐analysisobesitysuicidal behaviortype 2 diabetes mellitus

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