Trigger warning: This article mentions mental health issues like anxiety and depression, and talks about suicidal thoughts/suicide. Reader discretion is advisedThe Therapeutic Goods Administration (TGA) of Australia released a safety alert on November 30, 2025 to inform users about potential suicidal thoughts, depression and mood changes when using GLP-1 receptor agonists, including Ozempic. The safety notice affects semaglutide (Ozempic, Wegovy) and three other medications liraglutide (Saxenda), dulaglutide (Trulicity), tirzepatide (Mounjaro) which 500,000 Australians use for diabetes management, and weight control. No proven causal link exists, but the TGA standardized labels after reviewing 72 suicidal ideation reports, 6 depression-related suicides, 4 attempts, and 2 completions up to September 2025.How was the warning triggeredThe EMA (European Medicines Agency), FDA and WHO identified semaglutide suicidal thought reports, exceeding those of other diabetes medications in their adverse event databases. The TGA Advisory Committee on Medicines (ACM) evaluated the data, but concluded there was no proven link between the medications and adverse effects, while acknowledging obesity and diabetes create complex mental health relationships. The WHO database study from 2024 revealed increased signals which led to product label standardization.Dr. Terri-Lynne South from RACGP explains that people with depression, anxiety or those taking antidepressants, face higher risks of adverse effects. The mental changes that occur from fast weight loss resemble the psychological effects of bariatric surgery procedures. The TGA requires healthcare providers to assess patients’ mental health background, before starting GLP-1 receptor agonist treatment.
Understanding GLP-1 drugs and their riseGLP-1 Drugs work by imitating gut hormones to decrease hunger, delay stomach emptying, and enhance blood sugar management. The Australian government distributed more than 2 million subsidized semaglutide prescriptions during 2023-24, while weight loss prescriptions increased through social media promotion. The side effects of nausea and fatigue can create or intensify anxiety symptoms in patients.Research indicates that GLP-1 drugs affect dopamine reward systems in the brain, to produce mood changes. The TGA issued a separate warning about Mounjaro because patients experience decreased oral contraceptive effectiveness when their dosage changes.Reported various mental health problemsPatients experience anxiety, panic attacks and develop apathy while reporting self-harm thoughts, which seem to result from gastrointestinal side effects and body image changes due to rapid weight loss. The FDA conducted an analysis of 489 psychiatric adverse events, that occurred in U.S. patients who received semaglutide treatment. The incidence of adverse effects remains low according to trials, but vulnerable populations experience higher risks.
The actual number of events in real-world settings, exceeds what can be detected in controlled trials, because small study groups fail to identify rare occurrences. Users need to monitor for signs of depression and unusual conduct, and suicidal thoughts.Conflicted evidenceThe JAMA research evaluated four semaglutide clinical trials, which demonstrated psychiatric adverse events occurred at rates comparable to placebo in participants, without pre-existing conditions. Research indicates that GLP-1 medications help obese patients achieve better mental health outcomes by reducing their depression and anxiety symptoms through weight loss. The combination of obesity-related mental health risks with potential drug side effects, makes benefits more significant than risks for most patients.On the other hand, The Scientific Reports research established that GLP-1 medications increase depression, anxiety and suicidal thoughts through their effects on dopamine systems. The TGA maintains a cautious stance, because of conflicting research results while demanding additional studies.What does it mean for patientsPatients on these drugs, (and even otherwise) must inform their doctors immediately when they experience mood changes, develop depression, or experience self-harm thoughts. Patients with mental health conditions require complete risk assessment and ongoing monitoring, before starting treatment. They should stop their medication and seek immediate medical assistance, when they develop suicidal thoughts.Patients will achieve long-term success, by combining their medications with exercise, diet and therapy programs. Those who use these medications should receive annual mental health evaluations to ensure their safety.Disclaimer: This article is informational only and not a substitute for medical advice
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