The use of GLP-1 receptor agonists, like semaglutide, to treat type 2 diabetes is not associated with an increased risk of suicidality as previously suggested, an analysis of UK data has found.
A study comparing GP records of patients taking GLP-1RA drugs and those taking dipeptidyl peptidase-4 (DPP-4) inhibitors or sodium-glucose cotransporter-2 (SGLT2) inhibitors found no link with suicidal ideation, self-harm and suicide.
It follows a paper published last year which found an apparent disproportional risk of suicidal thoughts with semaglutide compared with other diabetes drugs.
The researchers detected the ‘signal’ after looking at adverse drug reaction data from around the world which needed further investigation.
In the latest study, the researchers found a crude association with semaglutide and risk of suicidality compared with other drugs but it disappeared once confounding factors were accounted for.
Writing in the BMJ, the researchers said that, despite previous concerns, the findings should ‘provide some reassurance’ about the psychiatric safety of the drugs.
The study included 36,082 patients using GLP-1RA drugs and 234,028 patients using DPP-4 inhibitors between 2007 and 2020.
Analysis was also done on 32,336 patients using GLP-1RA medicines and 96,212 patients using SGLT-2 inhibitors between 2013 and 2020.
Suicidality was defined as a composite of suicidal ideation, self-harm, and suicide but these were also looked at in isolation.
After taking into account age, sex, socioeconomic status, diabetes severity, and a history of mental ill health, the use of GLP-1 receptor agonists was not associated with an increased risk of suicidality compared with DPP-4 inhibitors (3.9 v 3.7 per 1000 person years, respectively).
Neither was there an increased risk of suicidality compared with SGLT-2 inhibitors (4.3 v 4.6 per 1000 person years, respectively).
Similar findings were found when suicidal ideation, self-harm, and suicide were looked at separately for all classes of drugs.
The findings are observational but the results were consistent which suggests they are robust, the researchers said.
‘At this point in time, data from clinical trials and observational studies in broad populations do not indicate that GLP-1 receptor agonists increase the risk of suicidality’, the Candian researchers concluded.
