Suicide‑related events made up under 0.3% of 42,941 European GLP‑1 safety reports, a count that cannot show cause

European drug regulators run a database called EudraVigilance, where doctors, companies and patients file reports of suspected side effects. A new analysis of that database, published on 27 August 2026 in Frontiers in Pharmacology, counted how often reports involving three obesity and diabetes drugs mentioned suicide or self-injury.

The researchers pulled every report filed between 1 January 2021 and 31 December 2025 that named liraglutide, semaglutide or tirzepatide as a suspected drug. After keeping only the reports where the drug was being used for weight management or type 2 diabetes, 42,941 reports remained. Semaglutide accounted for 25,178 of them, tirzepatide for 13,233 and liraglutide for 4,530.

225 suicide-related cases out of 42,941 reports

Suicide and self-injury events appeared in 37 reports for liraglutide, 141 for semaglutide and 47 for tirzepatide, or 225 cases in total. The authors write that these events made up less than 0.3% of all the side effects recorded across the three drugs.

Stomach and gut problems dominated instead. Nausea, vomiting and diarrhoea were the most frequently recorded complaints, followed by medication handling problems such as off-label use, and general symptoms such as fatigue.

Reports naming semaglutide and liraglutide mentioned these events more often

Using tirzepatide as the comparison, the researchers calculated a reporting odds ratio for each of the other two drugs. Liraglutide came out at 2.54, with a 95% confidence interval of 1.60 to 4.01. Semaglutide came out at 2.69, with a confidence interval of 1.91 to 3.83. A confidence interval is the range the true figure is likely to fall within.

That number is easy to misread. A reporting odds ratio compares how often an event shows up inside a pile of reports. It cannot say how many people taking the drug experienced the event, because nobody counts the people who took the drug and filed nothing.

Why a pile of reports cannot measure risk

The authors set out the reasons themselves. Anyone can file a report, and roughly half of these came from people who were not health professionals. Reports do not carry psychiatric history, so an existing mental health condition cannot be separated from the drug. Tirzepatide reached the market later than the other two and has fewer years of use behind it. And when a safety question draws heavy news coverage, reporting of that specific event rises, an effect the authors name as stimulated reporting and notoriety bias.

Their stated conclusion is that the findings do not establish a causal link, and do not contradict what regulators have concluded.

What the FDA found when it did try to measure risk

On 13 January 2026 the FDA asked the companies behind Saxenda (liraglutide), Wegovy (semaglutide) and Zepbound (tirzepatide) to remove the suicidal ideation and behavior warning from those products' labeling. The agency said its review found no increased risk.

Two pieces of work sat behind that request. The FDA pooled 91 placebo-controlled trials covering 107,910 patients, 60,338 of them taking a GLP-1 drug and 47,572 taking placebo. The pooled result showed no increased risk of suicidal thoughts or behavior, and no increase in anxiety, depression, irritability or psychosis. Separately, the FDA ran a study on insurance and health-record data through its Sentinel system, comparing 1,161,983 people starting a GLP-1 drug with 1,081,155 people starting an SGLT2 inhibitor, over the period from 1 October 2015 to 20 September 2023. After adjusting for differences between the groups at the start, it found no increased rate of intentional self-harm, including in the subgroup who had both type 2 diabetes and obesity.

Europe reached the same position earlier. In April 2024 the European Medicines Agency's safety committee said the available evidence does not support a causal association between GLP-1 receptor agonists and suicidal or self-injurious thoughts and actions, and that no change to the product information was warranted.

If you are having thoughts of suicide or self-harm, in the United States you can call or text 988 at any time. Tell your prescriber about any new or worsening depression or unusual change in mood, and do not stop a prescribed medicine without talking to them first.