Medication Management

GLP-1 Drugs and Mental Health: What We Know

By Dr. Stacey Forbes, DNP, APRN, PMHNP-BC · Updated October 12, 2026

GLP-1 drugs such as semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound) and liraglutide (Victoza, Saxenda) are now among the most prescribed medicines in the country, and many people taking them also take psychiatric medication. Questions about mood, suicidal thoughts and interactions are reasonable. The short version: after a review lasting about two and a half years, regulators found no evidence that these drugs cause suicidal thoughts, and the FDA removed the warning in 2026. There are still practical issues to coordinate between whoever prescribes your GLP-1 and whoever manages your mental health.

The suicidal-thoughts question: what regulators reviewed

In July 2023, after reports of suicidal thoughts in people taking GLP-1 drugs, both the FDA and the European Medicines Agency opened reviews. The weight-loss versions of these drugs (Wegovy, Zepbound and Saxenda) already carried a warning about suicidal behavior, borrowed from older weight-loss medicines. The diabetes versions never did.

In January 2024 the FDA shared preliminary findings: its review had not found evidence that the drugs cause suicidal thoughts or actions, but the numbers were too small to rule out a small risk, so the review continued. In April 2024 the EMA's safety committee (PRAC) concluded that the evidence did not support a causal link and that no change to product information was needed.

The FDA then ran a larger analysis. Its meta-analysis pooled 91 placebo-controlled trials with 107,910 participants. GLP-1 drugs did not increase suicidal thoughts or behavior, and did not increase anxiety, depression, irritability or psychosis either. A separate study of more than 2.2 million people with type 2 diabetes in the FDA's Sentinel claims database found no higher risk of intentional self-harm with GLP-1 drugs than with another class of diabetes medicine.

The 2026 label change, exactly

On 13 January 2026 the FDA issued a Drug Safety Communication asking the makers of Saxenda (liraglutide), Wegovy (semaglutide) and Zepbound (tirzepatide) to remove the information about suicidal behavior and ideation from their labeling, so that all GLP-1 labels would carry consistent messaging. The current prescribing information on DailyMed for all three now lists "Suicidal Behavior and Ideation … (Removed) 02/2026."

Two things did not change. First, the FDA still tells patients to report new or worsening depression, suicidal thoughts, or unusual changes in mood or behavior to a clinician. Second, the finding is about the drugs as a group, not a guarantee about any one person. Depression and suicidal thoughts are common in people living with obesity and diabetes for many reasons, and they deserve attention whatever the cause.

Mood effects: what the research suggests

Some observational studies point toward a possible benefit. A 2024 study in Nature Medicine using electronic health records from more than 240,000 people with overweight or obesity found that those prescribed semaglutide had a lower risk of new and recurrent suicidal thoughts than those prescribed other weight-loss medicines, a finding repeated in about 1.6 million people with type 2 diabetes. Observational studies cannot prove cause and effect, though: people who start a new, expensive drug may differ in many ways from those who do not.

Individual experiences also vary. Some people feel better as health and energy improve; others notice low mood, irritability or a flat feeling, sometimes tied to eating much less or to nausea. Some describe a quieter relationship with food and with other cravings. These experiences are real, but none of this makes a GLP-1 drug a treatment for depression, anxiety or addiction. No GLP-1 drug is FDA-approved for a psychiatric condition, and trials in those areas are still ongoing.

GLP-1 drugs and antipsychotic-related weight gain

This is where the evidence is strongest for people in psychiatric care. A 2026 network meta-analysis in JAMA Psychiatry compared 39 treatments for weight gain in people taking antipsychotics, across 95 trials. Semaglutide and liraglutide were among the options with moderate-certainty evidence of weight loss compared with placebo, alongside metformin, topiramate and exenatide. An earlier randomized trial of liraglutide in people taking clozapine or olanzapine found better blood sugar control and weight loss over 16 weeks, with mainly digestive side effects; that trial received funding from the drug's manufacturer.

Whether a GLP-1 drug makes sense for antipsychotic-related gain depends on your overall health, other options such as a dose review or switch, cost and coverage, and who will prescribe and monitor it. Our page on weight gain on psychiatric medication lays out the full range of options, and antipsychotic metabolic risks explains the monitoring involved.

Eating disorders: a reason for caution

GLP-1 drugs reduce appetite and the drive to eat. For someone with a current or past eating disorder, particularly anorexia, bulimia or binge-purge patterns, that can feed restriction, make it harder to recognize hunger, and complicate recovery. Rapid weight loss can also be rewarding in ways that reinforce disordered thinking.

That does not mean a GLP-1 drug is always ruled out, but it does mean whoever prescribes it should know your full history, and your mental health clinician should know you are taking it. If you notice yourself skipping meals beyond what the medication explains, using it to compensate for eating, or becoming preoccupied with the scale, raise it early.

Effects on your other medications

GLP-1 drugs slow how quickly the stomach empties. The Zepbound label warns that this can affect the absorption of oral medications, advises monitoring drugs that have a narrow margin between effective and toxic levels, and tells people using birth control pills to switch to a non-oral method or add a barrier method for four weeks after starting and after each dose increase. The Saxenda label notes that liraglutide did not change absorption of the oral drugs it tested to a clinically relevant degree, but still advises watching for problems.

For psychiatric medications, the practical concerns are:

• Nausea, vomiting and diarrhea, the most common side effects, can mean a dose of an oral medication is not absorbed, or can cause dehydration. With lithium, dehydration can push levels up, so tell your prescriber if you have ongoing stomach symptoms.
• Eating much less can change how you tolerate medications that are meant to be taken with food.
• Weight loss itself may change how you feel on some medications over time, which is worth a review after significant change.

Our sibling guides on interactions to check and lab monitoring cover the wider picture.

Coordinating care between prescribers

GLP-1 drugs are usually prescribed by a primary care clinician, endocrinologist or weight-management program, not by a psychiatric prescriber. That makes communication the most important safety step:

1. Tell each prescriber about every medication you take, including the GLP-1 dose and when it changes.
2. Ask your mental health prescriber whether any of your psychiatric medications need closer monitoring while you start or increase a GLP-1.
3. Report persistent nausea, vomiting, low mood or eating changes to both.
4. Do not stop or adjust psychiatric medication because you have lost weight without discussing it first.

At Willow & Stone, coordinating with your other clinicians is part of integrative medication management. Looking at the whole person, including metabolism, sleep and nutrition, is where GLP-1 questions belong.

Common Questions

Sources & Further Reading

• FDA — Drug Safety Communication: FDA requests removal of suicidal behavior and ideation warning from GLP-1 RA medications (13 Jan 2026)
• EMA — Meeting highlights from PRAC, 8–11 April 2024
• DailyMed — Zepbound (tirzepatide) prescribing information
• Wang et al., Association of semaglutide with risk of suicidal ideation in a real-world cohort (Nat Med, 2024)
• Stogios et al., Pharmacological interventions for weight reduction in patients treated with antipsychotics (JAMA Psychiatry, 2026)
• Larsen et al., Liraglutide in clozapine- or olanzapine-treated patients (JAMA Psychiatry, 2017)

This article is general education, not advice for your situation. Do not start, stop, or change a medication or supplement without talking to the clinician who prescribes it.