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GLP-1 receptor agonists and suicidality

BMJ 2025; 388 doi: https://doi.org/10.1136/bmj.r351 (Published 26 February 2025) Cite this as: BMJ 2025;388:r351

Linked Research

Glucagon-like peptide-1 receptor agonists and risk of suicidality among patients with type 2 diabetes

  1. Peter Ueda, assistant professor1 2,
  2. Björn Pasternak, principal researcher1 3
  1. 1Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
  2. 2Centre for Diabetes, Academic Specialist Centre, Stockholm, Sweden
  3. 3Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
  1. Correspondence to: P Ueda peter.ueda{at}ki.se

Evidence suggests no increased risk

The use of glucagon-like peptide-1 (GLP-1) receptor agonists has surged in recent years, driven by their benefits in glucose control in type 2 diabetes, weight reduction, and cardiovascular and renal outcomes. Given the increasing number of patients being treated with these drugs, timely assessment of potential safety signals is important.

In July 2023 the European Medicines Agency launched an investigation into thoughts of suicide and self-harm potentially linked to GLP-1 receptor agonists.1 Although meta-analyses of randomised controlled trials have not indicated that GLP-1 receptor agonists increase suicidality, depression, anxiety, and other adverse mental health outcomes, the clinical trials were not designed to assess those outcomes, and the statistical power of the analyses have been limited by the low number of events.23 In addition, most clinical trials have excluded patients at high risk of suicidality. In this situation, adequately designed observational …

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