Risk of suicidal ideation and suicidality among adults prescribed semaglutide for weight management: A population‐based cohort study
Authors' conclusion
Among patients initiating semaglutide for weight management, semaglutide did not appear to increase the risk of suicide-related outcomes. However, the CIs of the RDs are compatible with a 0.07% increase in 6-month risk and the true RD could be larger due to the potentially low sensitivity of ICD-10 diagnosis codes for and underreporting of suicide-related outcomes. Additional studies are critical to confirm these findings and obtain more precise estimates of any potential benefits or harms of semaglutide.
Study context
- Population
- Overweight or obese adults without prior suicidality or T2D, ≥1 year continuous health and pharmacy coverage, new users initiating between 01 June 2021 and 31 December 2022; Merative MarketScan Databases
- Participants
- 16,822 vs 11,986
- Exposure
- Semaglutide vs active comparator weight management drugs
- Semaglutiden = 16,822
- Active comparatorsn = 11,986reference
- Outcome
- Incident suicidal ideation (SI) and suicidality (SI, suicide attempt or intentional self-harm), by diagnosis codes
- Follow-up
- Within 183 days of drug initiation
Methodological detailspopulation-based, new-user active-comparator design, standardized mortality ratio weights
- Population-based
- New-user active-comparator design
- Standardized mortality ratio weights
Main finding
As reported in the abstract
Incident SI (adjusted risk) · 183 days
Each group vs active comparatorsAdjusted RD (95% CI)
Semaglutide
0.02%(−0.02% to 0.07%)
Each group vs active comparatorsRelative risk (95% CI)
Semaglutide
1.36(0.62–6.14)
Observational data: associations, not effects.
Further findings
| Outcome | Semaglutide | Active comparators | Adjusted RD (CI) | |
|---|---|---|---|---|
| Incident suicidality (adjusted risk) · 183 days | 0.08% | 0.07% | 0.02% (−0.03% to 0.07%) | |
| −0.0500.050.1Difference (linear scale) |
| Outcome | RR (CI) | |
|---|---|---|
| Incident suicidality (adjusted risk) · 183 days | 1.18 (0.57–3.63) | |
| 0.20.5125Relative risk (log scale) |
Original publication
Risk of suicidal ideation and suicidality among adults prescribed semaglutide for weight management: A population‐based cohort study. Diabetes Obes Metab. Published 4 August 2025. doi:10.
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