Australia’s drug regulator has raised concerns over the mental health implications of semaglutide, a medication increasingly prescribed for weight loss and diabetes management. The alert comes after more than two million prescriptions for the drug have been issued under the Pharmaceutical Benefits Scheme. We know this data includes the 2023-24 hires. This massive adoption has led health authorities to carefully watch its impacts on mental health.
Semaglutide, which is sold under the brand names Ozempic, Rybelsus, and Wegovy, among others, has garnered acclaim for its remarkable diabetes management and weight-loss benefits. This 2024 study examined the World Health Organization’s global database of adverse reactions. Through its analysis, the FDA made an astounding discovery of an at first unanticipated increase in reports of suicidal ideation associated with its use. This has resulted in the addition of two new safety warnings—one relating to mental health and one relating to contraception.
Dr Terri-Lynne South, deputy chair of the Royal Australian College of General Practitioners’ specific interest group on obesity management. This interdisciplinary group is at the cutting edge in measuring semaglutide’s positive impacts on patients. In her role, Dr. South has noted that significant or rapid weight loss induced by the drug can act as a “real triggering event from a mental health point of view.”
Additionally, there are fears about semaglutide’s impact on oral contraception. The medicines regulator is investigating how the medication can lower the effectiveness of combined birth control pills. This is particularly critical when patients are initiating or up-titrating semaglutide. Dr. South explained the mechanism behind this issue, stating:
“What that means is [the drug] delays the food and everything else that you eat actually coming through the digestive system, and therefore having an impact on the absorption of the oral contraceptive pill, and therefore possibly the effectiveness of the oral contraceptive pill.”
The relationship between semaglutide and mental health is complicated. Dr. South emphasized that there may exist a subgroup of patients who are more susceptible to deteriorating mental health while using this medication. She clarified that these people could be anyone with a past of depression or anxiety. Furthermore, it could even include those who are on antidepressants now.
“We do think there might be a subgroup of patients who may be more vulnerable to a worsening of their mental health,” – Dr. Terri-Lynne South.
Continued debate over the long-term impacts of semaglutide have fueled this examination. Other associations might only become apparent after 30,000-50,000 patients have been exposed to the drug under real-world conditions. In the months following semaglutide’s release in Australia, patients experienced some troubling side effects. In addition to mental health side effects, many people are having problems with delayed gastric emptying.
In light of these changes, healthcare providers need to closely review patients’ histories before prescribing semaglutide. This is critical for people who had mental health needs prior to the pandemic. Patients are encouraged to remain vigilant and seek support if they experience any distressing thoughts or feelings while on the medication.
If you’re located in Australia and you require support, please contact Lifeline at 13 11 14. In the U.S., you can reach the 988 Suicide & Crisis Lifeline by calling 988 or going to 988lifeline.org .