Association of semaglutide with risk of suicidal ideation in a real-world cohort
- Design
- Retrospective cohort · 240618 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Different populationEHR cohorts with obesity or diabetes; younger than target.
- Could weight loss explain it?
- UnknownSafety outcome.
- Study tier
- Study tier 3Large propensity-matched EHR cohort; observational; short follow-up.
- Assessment
- Version 2 · curated · Sep 13, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
In 240,618 US patients with overweight or obesity, semaglutide was associated with lower, not higher, rates of suicidal thoughts compared with other weight-loss drugs over six months. Publicly funded; does not support the suicidality concern.
01Findings
What the study reported
- Drugs
- Semaglutide
- Comparator
- non-GLP-1 anti-obesity or antidiabetic medications
- Primary outcome
- Incident and recurrent suicidal ideation over 6 months
- Effect
- Incident HR 0.27; recurrent HR 0.44 (obesity cohort); replicated in T2D
- 95% confidence interval
- 0.32 to 0.60 (recurrent)
- Follow-up
- 6 months
- Adverse events
- Not extracted
- Limitations
- Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.
Who was studied
- Mean age
- 50.1
- Sex distribution
- 72.6% female
- Obesity status
- overweight/obesity cohort; T2D replication cohort
- Diabetes status
- separate cohorts
- Sample size
- 240618
Study quality details
- Study design
- Retrospective cohort
- Sample size
- 240618
- Randomization
- no
- Blinding
- not stated
- Comparator
- not stated
- Follow up duration
- 50.1 years
- Outcome type
- unknown
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- INDIRECT
- Statistical precision
- large cohort
- Risk of bias
- EHR diagnosis codes; residual confounding; short follow-up
- Funding conflicts
- no
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- NIH (NIA, NIAAA, NICHD, NCI)
- Industry funded
- No
- Manufacturer
- None identified
- Sponsor role
- Independent.
- Author conflicts
- Authors declare no competing interests.
- Independent replication
- yes (Nordic registers, PMID 39226030)
Funding is shown on every study and never used to score it.
03Claims
Claims this study bears on
- GLP-1 receptor agonists increase suicidal ideation or suicide.Contradicts
TriNetX: HR 0.27 for incident suicidal ideation vs non-GLP-1 anti-obesity drugs.
04Source
The source, as retrieved
Abstract
Concerns over reports of suicidal ideation associated with semaglutide treatment, a glucagon-like peptide 1 receptor (GLP1R) agonist medication for type 2 diabetes (T2DM) and obesity, has led to investigations by European regulatory agencies. In this retrospective cohort study of electronic health records from the TriNetX Analytics Network, we aimed to assess the associations of semaglutide with suicidal ideation compared to non-GLP1R agonist anti-obesity or anti-diabetes medications. The hazard ratios (HRs) and 95% confidence intervals (CIs) of incident and recurrent suicidal ideation were calculated for the 6-month follow-up by comparing propensity score-matched patient groups. The study population included 240,618 patients with overweight or obesity who were prescribed semaglutide or non-GLP1R agonist anti-obesity medications, with the findings replicated in 1,589,855 patients with T2DM. In patients with overweight or obesity (mean age 50.1 years, 72.6% female), semaglutide compared with non-GLP1R agonist anti-obesity medications was associated with lower risk for incident (HR = 0.27, 95% CI = 0.200.32-0.600.36) and recurrent (HR = 0.44, 95% CI = 0.32-0.60) suicidal ideation, consistent across sex, age and ethnicity stratification. Similar findings were replicated in patients with T2DM (mean age 57.5 years, 49.2% female). Our findings do not support higher risks of suicidal ideation with semaglutide compared with non-GLP1R agonist anti-obesity or anti-diabetes medications.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Sep 13, 2026 | 38182782 first ingestion |