Daily Dose: Semaglutide Not Linked to Suicide Ideation

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in Nature Medicine that examined the associations of semaglutide with suicidal ideation compared to other non-glucagon-like peptide 1 receptor (GLP1R) agonist antiobesity or antidiabetes medications.

The study

Researchers used US electronic health records from the TriNetX Analytics Network, and followed participants for 6 months to examine the first incidence and relapse of suicidal ideations.

The first cohort consisted of 240 628 patients with obesity or overweight (mean age, 50.1 years, 72.6% women, 16% Black) and were prescribed semaglutide or non-GLP1R agonist antiobesity medications from June 2021 through December 2022. Among the cohort, 232 771 individuals did not have a history of suicidal ideation and 7847 did.

In the second analysis, investigators replicated the original investigation with 1 589 855 patients with T2D (mean age, 57.5 years, 49.2% women, 15.4% Black) who were prescribed semaglutide or non-GLP1R antidiabetes medications from December 2017 through May 2021. Among this cohort, 1 572 885 participants did not have a prior history of suicidal ideation and 16 970 did.

Patients in both cohorts were matched for demographic characteristics, medical history, lifestyle issues, mental and substance use disorders, and prior suicidal ideation and behavior.

The findings

Among participants with obesity or overweight, those taking semaglutide had a significantly lower risk of suicidal ideation compared with those who received non-GLP1R antidiabetes medications (0.11% vs 0.43%; hazard ratio [HR] 0.27, 95% CI 0.20-0.36).

Similarly, in the second cohort of patients with T2D, results showed that the semaglutide group had a significantly lower risk for incident suicidal ideation than the matched non-GLP1R agonist antiobesity medication group (0.13% vs 0.36%; HR 0.36, 95% CI 0.25-0.53).

Patients with obesity or overweight who received semaglutide had a significantly lower risk of recurrent suicidal ideation compared with those taking other non-GLP1R agonist obesity medications (6.5% vs 14.1%; HR 0.44, 95% CI 0.32-0.60).

Authors' comment

"Our findings do not support higher risks of suicidal ideation with semaglutide compared with non-GLP1R agonist anti-obesity or anti-diabetes medications...further studies should evaluate the association of semaglutide and other GLP1R agonist medications with the incidence and recurrence of suicidality in other at-risk populations."

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