Like its U.S. and European counterparts, Britain’s Medicines and Healthcare Products Regulatory Agency found no conclusive link between the use of GLP-1s and a heightened risk of suicidal and self-injury thoughts.
The U.K.’s Medicines and Healthcare Products Regulatory Agency on Wednesday found no link between the use of GLP-1 receptor agonists and an elevated risk of suicidal or self-injury ideation.
Following reports of psychiatric side effects in patients taking the obesity medications, the regulatory agency conducted a review, looking at post-marketing data for five GLP-1 therapies: exenatide, lixisenatide, luraglutide, dulaglutide and Novo Nordisk’s blockbuster semaglutide. In addition to suicidal thoughts and self-harm, the Medicines and Healthcare Products Regulatory Agency (MHRA) assessed potential effects of GLP-1 drugs on the risk of depression.
The investigation concluded that “the available evidence does not support a causal association between GLP-1 receptor agonists and suicide, suicidal ideation, self-injury and depression,” according to MHRA’s announcement.
While MHRA will “continue to closely monitor” the potential effects of using GLP-1 receptor agonists on “severe psychiatric reactions,” the agency does not currently recommend updates to the product information sheets of the specific drugs in the review.
MHRA’s probe adds to the ongoing debate about the safety of these new obesity treatments, particularly regarding their potential suicide and self-injury risks. While the evidence so far has largely suggested an absence of psychiatric adverse events, an editor’s note published Wednesday in JAMA Internal Medicine contends that more studies are needed—especially in patients with preexisting mental health conditions.
The potential risk of suicidal ideation and self-injury associated with GLP-1 therapies was first flagged in July 2023 when the European Medicines Association (EMA) reported an uptick in these side effects in patients who were on semaglutide and liraglutide. As part of its investigation, EMA in December 2023 asked for “further clarifications” from the GLP-1 drugmakers, though it did not reveal what specific information it needed.
In April 2024, the EMA announced that it had found no evidence to suggest a causal relationship between GLP-1 therapies and these psychiatric side effects.
The FDA in January 2024 also launched a review of GLP-1 receptor agonists and announced a week later that it had no reason to believe that these drugs caused thoughts of suicide or self-harm.
Still, some doubts remain. Last month, a large study published in JAMA Network Open used data from the World Health Organization’s drug safety database—which according to the researchers is the “largest pharmacovigilance archive worldwide”—and found an elevated risk of suicidal ideation associated with semaglutide versus other drugs.
This effect was particularly pronounced in people who were also on antidepressants, in whom semaglutide worsened the risk of suicidal thoughts by more than fourfold.
