Association of glucagon‑like peptide‑1 receptor agonists with suicidal ideation and self‑injury in individuals with diabetes and obesity: a propensity‑weighted, population‑based cohort study – published online 06/08/2024

Isabel Hurtado, Celia Robles, Salvador Peiró, Aníbal Garcia‑Sempere, Gabriel Sanfelix‑Gimeno

The popularity of GLP-1 receptor agonists (GLP-1RAs) has risen steeply since they received approval as weight loss agents, fuelled by substantial media attention. Meanwhile, regulatory agencies are investigating a potential link between GLP-1RAs and an increased risk of suicidal ideation and self-injury (SIS), and are calling for additional pharmacoepidemiological evidence. In this issue, Hurtado et al (https://doi.org/10.1007/s00125-024-06243-z) evaluate the risk of SIS in people with diabetes and obesity who initiated either GLP-1RAs or the comparator drug class sodium–glucose cotransporter 2 inhibitors (SGLT-2i) in a southern European region with a population of 5 million, from 2015 to 2021. Across several analyses, the authors did not observe a higher risk of SIS among GLP-1RA initiators, which aligns with the most recent regulatory reports. However, the authors conclude that, because of the rarity and potential severity of SIS events, a causal link between GLP-1RAs and suicidality cannot be entirely ruled out, and cautious use and monitoring of GLP-1RAs are warranted.