GLP-1 Receptor Agonist Use and Risk of Suicide Death
- Design
- Retrospective cohort · 298553 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Different populationMostly type 2 diabetes; mean age 60 overlaps target. Register-based, high-quality outcome ascertainment.
- Could weight loss explain it?
- Unknown[Auto] Participants had obesity and/or type 2 diabetes and the abstract does not separate direct drug effects from weight loss or glycaemic improvement.
- Study tier
- Study tier 3Well-designed register study; rare outcome limits precision but excludes large absolute increases.
- 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.
Across Sweden and Denmark, 124,517 new GLP-1 users and 174,036 SGLT2-inhibitor users had similar, very low suicide death rates over 2.5 years. The data exclude more than 0.16 extra suicide deaths per 1,000 person-years.
01Findings
What the study reported
- Drugs
- Class unspecified
- Comparator
- SGLT2 inhibitors (active comparator, new-user design)
- Primary outcome
- Suicide death (national cause-of-death registers, Sweden and Denmark)
- Effect
- HR 1.25; absolute difference 0.05 per 1000 person-years; self-harm composite HR 0.83; depression/anxiety HR 1.01
- 95% confidence interval
- 0.83 to 1.88
- Follow-up
- mean 2.5 years
- 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
- 60
- Sex distribution
- 45% female
- Diabetes status
- mostly type 2 diabetes
- Sample size
- 517
Study quality details
- Study design
- Retrospective cohort
- Sample size
- 517
- Randomization
- no
- Blinding
- not stated
- Comparator
- active comparator
- Follow up duration
- 84 years
- Outcome type
- hard
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- INDIRECT
- Statistical precision
- 148 suicide deaths; CI upper bound 1.88
- Risk of bias
- active-comparator new-user design minimises bias; observational
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- Non-US government / foundation (per PubMed)
- Industry funded
- No
- Manufacturer
- None identified
- Sponsor role
- not reported in abstract
- Author conflicts
- See published disclosures.
- Independent replication
- yes (US EHR cohort)
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
Nordic registers: suicide death HR 1.25 (0.83-1.88); self-harm composite HR 0.83.
04Source
The source, as retrieved
Abstract
[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.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Sep 13, 2026 | 39226030 first ingestion |