Summary: A new study has found no evidence that GLP-1 analogues, common diabetes drugs, increase the risk of suicide, self-harm, or related mental health issues. Researchers analyzed data from around 300,000 people treated with these medications and found no clear link between the drugs and mental health risks.
This finding supports previous conclusions by European authorities and provides reassurance for millions of users. However, further studies are recommended, especially for individuals with a history of self-harm or suicidal thoughts.
Key Facts:
- No increased risk of suicide, self-harm, or depression was found with GLP-1 drugs.
- Data from 300,000 adults in Sweden and Denmark was analyzed over two years.
- Further research is needed for those with a history of mental health concerns.
Source: Karolinska Institute
There has been concern that common diabetes drugs could increase the risk of suicide and self-harm. In a new study, led by researchers at Karolinska Institutet and published in Jama Internal Medicine, no such risk increase was observed.
Drugs of the type GLP-1 analogues lower blood sugar levels and are used by millions of people worldwide. They are mainly used to treat diabetes, but drugs such as Ozempic have also been shown to be effective against obesity, which has increased their popularity.
At the same time, both American and European drug authorities have warned that there may be risks associated with the drugs.
Last year, the European Medicines Agency (EMA) launched an investigation following around 150 reported possible cases of suicidal thoughts and self-injury with use of GLP-1 analogues.
The investigation was completed in the spring and based on the limited data available at the time, it concluded that there were no obvious connections. Researchers at Karolinska Institutet can now further support this conclusion. They have analyzed large amounts of data from people treated with GLP-1 analogues in Sweden and Denmark .
“We found no clear link between the use of the drugs and an increased risk of suicide death, self-harm or depression and anxiety-related disorders. This is reassuring.” says Björn Pasternak, principal researcher at the Department of Medicine, Solna, Karolinska Institutet, and one of the study’s lead authors.
The data includes approximately 300,000 adults aged 18–84 who started treatment with either GLP-1 analogues or SGLT2 inhibitors, another type of diabetes medication, during the years 2013–2021.
After a mean follow-up period of just over two years, there was no apparent increase in the proportion of people who committed suicide, engaged in self-harm, or suffered from depression or anxiety-related disorders among users of GLP-1 receptor agonists.
Peter Ueda, assistant professor at the same department and one of the study’s main authors, nevertheless emphasizes the importance of larger studies as more data is collected.
“It is important to specifically examine people with previous self-harm or suicidal thoughts as they are at increased risk and it is possible that the drug’s safety profile differs in this group,” he says.
Funding: The study was conducted in collaboration with researchers in Denmark and mainly funded by Karolinska Institutet. Some of the researchers report conflicts of interest, see the study for more information.
About this neuropharmacology and mental health research news
Author: Press Office
Source: Karolinska Institute
Contact: Press Office – Karolinska Institute
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Original Research: Open access.
“GLP-1 receptor agonists and risk of suicide death: nationwide cohort study in Sweden and Denmark” by Björn Pasternak et al. JAMA Internal Medicine
Abstract
GLP-1 receptor agonists and risk of suicide death: nationwide cohort study in Sweden and Denmark
Importance
Concerns have been raised regarding a link between use of glucagon-like peptide-1 (GLP-1) receptor agonists and increased risk of suicidality and self-harm.
Objective
To assess the association between use of GLP-1 receptor agonists and the risk of suicide death in routine clinical practice.
Design, Setting, and Participants
This active-comparator new-user cohort study used nationwide register data from Sweden and Denmark from 2013 to 2021. Adults 18 to 84 years old who initiated treatment with GLP-1 receptor agonists or the comparator sodium-glucose cotransporter-2 (SGLT2) inhibitors were included. Data were analyzed from March to June 2024.
Exposure
Initiation of treatment with a GLP-1 receptor agonist or SGLT2 inhibitor.
Main Outcomes and Measures
The primary outcome was suicide death recorded in the cause of death registers. Secondary outcomes were the composite of suicide death and nonfatal self-harm and the composite of incident depression and anxiety-related disorders. Using propensity score weighting, hazard ratios (HRs) with 95% CIs were calculated separately in the 2 countries and pooled in a meta-analysis.
Results
In total, 124 517 adults initiated a GLP-1 receptor agonist and 174 036 initiated an SGLT2 inhibitor; among GLP-1 receptor agonist users, the mean (SD) age was 60 (13) years, and 45% were women. During a mean (SD) follow-up of 2.5 (1.7) years, 77 suicide deaths occurred among users of GLP-1 receptor agonists and 71 suicide deaths occurred among users of SGLT2 inhibitors: weighted incidences were 0.23 vs 0.18 events per 1000 person-years (HR, 1.25; 95% CI, 0.83-1.88), with an absolute difference of 0.05 (95% CI, −0.03 to 0.16) events per 1000 person-years. The HR was 0.83 (95% CI, 0.70-0.97) for suicide death and nonfatal self-harm, and the HR was 1.01 (95% CI, 0.97-1.06) for incident depression and anxiety-related disorders.
Conclusions and Relevance
This cohort study, including mostly patients with type 2 diabetes, does not show an association between use of GLP-1 receptor agonists and an increased risk of suicide death, self-harm, or incident depression and anxiety-related disorders. Suicide death among GLP-1 receptor agonist users was rare, and the upper limit of the confidence interval was compatible with an absolute risk increase of no more than 0.16 events per 1000 person-years.
