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Assessing the shadows: A meta-analysis of GLP-1 agonists and suicidal ideation

Amal Omar Alansari1, Ahlam Saleem Alharbi1, Khaled Mohammad Alshehri1

  • 1Department of Family Medicine, Third Health Cluster, Ministry of Health, Riyadh, Saudi Arabia.

Medicine
|December 10, 2025
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 agonists) show no significant link to suicidal ideation or completion in patients with diabetes and obesity. However, liraglutide use was associated with higher suicide rates compared to semaglutide.

Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Psychiatry

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1 agonists) have transformed obesity treatment.
  • Regulatory agencies have noted potential associations between GLP-1 agonist use and suicidality.
  • This meta-analysis is the first to specifically examine this association in patients with diabetes and obesity.

Purpose of the Study:

  • To evaluate the association between GLP-1 agonist use and suicidal ideation.
  • To assess the link between GLP-1 agonist use and suicide completion.
  • To compare these risks in patients with diabetes and obesity.

Main Methods:

  • A comprehensive search of 6 databases was conducted up to October 2024.
  • Keywords included GLP-1 agonists, suicidal ideation, suicide, and specific drug names (semaglutide, liraglutide, etc.).
  • 12 eligible studies were included in the final meta-analysis after screening 354 initial studies.

Main Results:

  • No significant difference in suicidal ideation was found between GLP-1 agonist users and controls (OR, 1.0; 95% CI: 1.0-1.0).
  • No significant difference in completed suicide was observed between groups (OR, 1.77; 95% CI: 0.80-3.91).
  • Subgroup analysis revealed higher suicide rates with liraglutide versus semaglutide (OR, 1.48; 95% CI: 1.17-1.89), but no difference between semaglutide and monjaro.

Conclusions:

  • GLP-1 agonists do not appear to significantly increase the risk of suicide or suicidal ideation compared to other obesity/diabetes drugs.
  • Liraglutide showed a higher incidence of suicide compared to semaglutide.
  • Further randomized controlled trials are recommended to definitively assess the association between GLP-1 agonists and suicidality.
Keywords:
glucagon-like receptors-1 agonistsliraglutidesemaglutidesuicidal ideationsuicidetirzepatide

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