Document Type

Article

Publication Date

5-18-2026

Keywords

glucagon‐like Peptide‐1 receptor agonists, suicidal ideation, suicide, systematic review

Abstract

Aims: We aimed to examine the association between GLP-1 RA use and suicidal ideation or behaviours through a systematic review of observational studies. Materials and methods: A comprehensive search of MEDLINE, PubMed, EMBASE, CINAHL and PsycINFO was conducted from database inception through December 11, 2025. Observational studies investigating suicidal ideation, suicide attempts or complete suicide among adults using GLP-1 RAs were included. Eligibility screening, data extraction and risk of bias assessments were performed independently and in duplicate, with disagreements resolved by a third reviewer. Results: Forty-three studies were included. Findings varied by study design. Some case reports suggested a temporal relationship between GLP-1 RA use and suicidal ideation. Cross-sectional studies and case-control studies identified a negative association between GLP-1 RAs and suicide attempts. Pharmacovigilance and cohort studies showed more mixed results, with some studies identifying a positive association between semaglutide or liraglutide and suicidal ideation, while others paradoxically reported a negative association with suicidal behaviours (i.e., attempts and intentional self-harm) or completed suicide. Conclusions: While evidence does not support GLP-1 RAs as a causative agent for suicidality, due to multiple risk factors in this population, clinicians should routinely assess mental health status before and during GLP-1 RA treatment regardless of indication. Importantly, a history of concurrent mental health conditions should not preclude use of a GLP-1 RA; rather, individual patient factors should be accounted for when making prescribing decisions.

Comments

10.1111/dom.70878

Publisher Attribution

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2026 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd

Creative Commons License

Creative Commons Attribution-Noncommercial 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License

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