Can Ozempic trigger depression or suicidal thoughts? Australia weighs in

Australia has issued a safety alert on GLP-1 drugs after reviewing reports of depression and suicidal thoughts; while there is no proven causal link, regulators want users to stay alert

Australia has issued new safety warnings for popular weight-loss and diabetes drugs such as Ozempic, Wegovy and Mounjaro, after reviewing reports of depression, anxiety and suicidal thoughts in some users.

 

Although there is still no proven causal link, the Therapeutic Goods Administration (TGA), the Australian government’s medicine and therapeutic regulatory agency, said in a precautionary safety alert that updated labels are needed so patients and doctors stay alert to mood changes as the use of these drugs continues to surge.

 

Originally designed for type 2 diabetes, GLP-1 drugs mimic gut hormones to regulate blood sugar, curb appetite and slow digestion.

 

 

According to media reports, this move follows global signals flagged by the European Medicines Agency (EMA), the US Food and Drug Administration (FDA), and the World Health Organization, all of whom noted that semaglutide (Ozempic/Wegovy) showed more reports of suicidal thoughts than other diabetes medicines in international databases.

What exactly did Australia’s TGA warn about?

The TGA’s alert standardises safety labels across widely used GLP-1 receptor agonists:

• Ozempic (semaglutide)
• Wegovy (semaglutide)
• Mounjaro (tirzepatide)
• Saxenda (liraglutide)
• Trulicity (dulaglutide)

The warning highlights possible risks of depression, anxiety, suicidal thoughts and behavioural changes. It asks doctors to actively monitor patients for:

• New or worsening depression
• Unusual mood changes
• Thoughts of self-harm

The update is precautionary because while reports exist, trials have not demonstrated a proven causal relationship.

Can GLP-1 drugs like Ozempic cause depression or suicidal thoughts?

A major 2024 JAMA Internal Medicine study, Psychiatric safety of semaglutide for weight management in adults with overweight or obesity, which analysed four semaglutide trials, found psychiatric adverse events occurred at similar rates to placebo, but only in people without pre-existing mental health conditions.

 

Some research even shows improved mood because weight loss reduces obesity-related depression and anxiety.

 

A 2024 Scientific Reports study, The risk of depression, anxiety, and suicidal behavior in patients with obesity on glucagon-like peptide-1 receptor agonist therapy, concluded that GLP-1 drugs may influence dopamine reward pathways, which play a key role in mood regulation, raising a theoretical risk of depression and suicidal thoughts.

 

Clinicians have also noted that rapid weight loss, whether from bariatric surgery or medication, can trigger emotional turbulence, identity changes, anxiety and apathy.

How could these drugs influence mood?

Researchers are exploring several possible mechanisms:

• Changes in dopamine signalling may alter motivation and reward perception
• Nausea, fatigue and appetite suppression, which are known side effects, can heighten anxiety in sensitive individuals
• Rapid changes in body image during weight loss can destabilise emotional wellbeing
• Physiological stress of weight reduction may mimic psychological effects seen after bariatric surgery, which is known to increase short-term vulnerability to mood swings

Do the benefits still outweigh the risks?

According to scientific papers published in multiple journals, GLP-1 drugs can improve blood sugar control, reduce weight, and lower risks of heart disease and diabetes complications.

 

Many studies show improved mental health, not worsened, after significant weight loss.

 

However, emerging psychiatric signals mean close monitoring is crucial, not discontinuation for all. 

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