A study has found an association between a drug used primarily for weight reduction and reports of suicidal thoughts, leading researchers to call for “urgent” investigation.
The drug semaglutide is sold under the brand name Ozempic in Australia and is only approved for the treatment of diabetes,
Semaglutide is also marketed overseas for weight loss under the brand name Wegovy.
A new study published in analysed data in the adverse drug reactions database of the World Health Organization and found a disproportionate number of people reported suicidal thoughts while using semaglutide.
The researchers said the effect remained “significant” compared to other diabetes medications.
The study also found suggestions that people with anxiety and depressive disorders were more likely to report suicidal thoughts when taking semaglutide.
A ‘wake-up call’
The researchers said the findings “warrant urgent clarification”.
Trevor Steward, a neurobiology researcher from the University of Melbourne, said the study should be a “wake-up call” for supporting larger studies around how semaglutide medications impact the brain.
“The study raises key questions about whether additional precautions are needed when prescribing semaglutide,” he said.
Margaret Morris, a professor of pharmacology from the University of New South Wales said the JAMA Network study had several limitations, including adjusting for things like alcohol and substance misuse and off-label use, as well as a lack of information about dosages.
The authors also acknowledged these limitations of the study and said the study could not infer causality and attribute any of the reactions to the effect of semaglutide.
However, they also said the findings should raise concerns, particularly for people who may be drawn to using semaglutide from social media accounts and may not understand the risks.
Semaglutide and suicidal thoughts
Anecdotal reports from users and families who have lost relatives to suicide have made the connection between semaglutide use and the onset of suicidal thoughts.
The European Medicines Agency (EMA) published a statement in July last year saying authorities had received around 150 reports of self-injury and suicidal thoughts associated with semaglutide and liraglutide, another drug in the same class.
However, both the EMA and the US Food and Drug Administration have said this year that there is no evidence for a causal association between semaglutide and self-harm or suicidal thoughts.
However, the Wegovy product information in the US tells users to monitor for depression or suicidal thoughts.
The new JAMA Network study also contradicts some previous findings that semaglutide use does not lead to higher risks of suicidal thoughts.
Another study published in in January found semaglutide was associated with a lower risk of suicidal thoughts compared to other anti-obesity and anti-diabetes drugs.
Semaglutide use in Australia
The use of semaglutide for weight loss in Australia is considered ‘off label’, meaning it has been prescribed for a purpose outside of its approved use.
Off-label prescriptions of Ozempic for weight loss have been driving shortages which the Therapeutic Goods Administration (TGA) believes will last until 2025.
The high demand for semaglutide products prompted the government to release a warning earlier this year about compounded replica drugs.
The TGA said it does not have the power to regulate the clinical decisions of health professionals and curb the off-label prescription of Ozempic, however it is trying to address the shortage of this medication.
