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GLP-1 Receptor Agonists and Suicidal Ideation: A Cautionary Consideration for Patients with Psychiatric Diagnoses
Introduction
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as liraglutide, semaglutide, and dulaglutide have transformed the management of type 2 diabetes mellitus (T2DM) and obesity. While their efficacy in glycemic control and weight reduction is well established, emerging post-marketing reports and regulatory investigations have raised concerns about potential neuropsychiatric adverse effects, particularly suicidal ideation, in susceptible populations.
Pharmacists, as accessible healthcare providers, are uniquely positioned to monitor for early warning signs of neuropsychiatric side effects, especially in patients with a known history of mental illness.
The Neuropsychiatric Safety Signal
In 2023, the European Medicines Agency (EMA) initiated a review of GLP-1 RAs following reports of suicidal thoughts and self-injury in patients using semaglutide and liraglutide, particularly for weight loss indications1. The U.S. FDA also began evaluating similar safety data. While a causal relationship has not been definitively established, the reports prompted heightened scrutiny due to the seriousness of the potential…