Can semaglutide cause anxiety? What the research says

Semaglutide (sold as Ozempic and Wegovy) is widely used for weight loss and type 2 diabetes. While the most common side effects are digestive, some people still ask: Can semaglutide cause anxiety? Here’s what the research shows. 

As weight loss medication becomes more and more popular, so does the buzz around potential side effects. New (and existing) weight loss medication users may wonder whether semaglutide (which you may know by the brand names such as Ozempic and Wegovy) can cause anxiety. The short answer is it’s not a common side effect, but it has been reported in some instances.

In large clinical trials, anxiety did not show up as a side effect. Most people experienced common side effects like nausea, stomach upset, or constipation instead. However, since the drug became more widely used, hundreds of people have posted on various social media platforms about feeling anxious, low in mood, or depressed after starting it.

These reports seem rare, but they’ve been enough to prompt researchers and regulators to take a closer look.

In 2023, the European Medicines Agency’s safety committee announced they would be reviewing data on GLP-1 receptor agonists like Ozempic, Wegovy, and Saxenda after reports of suicidal thoughts and self-injury in some users. But after reviewing the data, EMA’s safety committee announced that they found no evidence that GLP-1 medications cause suicidal thoughts or behaviors. The U.S. Food and Drug Administration (FDA) also conducted a similar investigation and found no clear evidence of a connection. The FDA also stated that a small risk cannot be completely ruled out and will continue to study the issue. 

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Does semaglutide make you anxious? Here’s what we know so far:

• Big picture: Research shows that reports of mood-related side effects, including anxiety, make up only about 1% of all side effects linked to semaglutide and similar medications. It’s not considered one of the main issues healthcare providers see with this treatment.

• Individual stories: There are some social media accounts and user reports of people who developed depression or anxiety symptoms after starting semaglutide, which improved once they stopped the medication.

• Emerging research: An analysis of more than 8,200 reports in the FDA’s Adverse Event Reporting System (FAERS) found an association between GLP-1 medications (like semaglutide) and symptoms such as nervousness, stress, insomnia, and changes in eating behavior. But an association does not prove that the medications directly caused these effects.

• Clinical trial evidence: An analysis of several clinical trials for weight loss, people taking semaglutide 2.4 mg had similar rates of anxiety and other mental health issues as those taking a placebo. This suggests semaglutide doesn’t seem to increase the risk of anxiety or other mood issues. 

• Link to less anxiety: A study of medical records of 4 million people found that semaglutide was linked to a lower likelihood of being diagnosed with anxiety — both in people with diabetes and in those without diabetes using it for weight loss. Again, a link does not prove a cause-and-effect relationship, but gives another clue to suggest that semaglutide isn’t likely to increase anxiety.

So, anxiety can occur while taking semaglutide, but the medication isn’t necessarily the cause. It’s important to pay attention to how you’re feeling and let a healthcare professional know if you experience new or worsening anxiety.

We don't know for sure why anxiety on semaglutide can happen, but here are the most likely explanations:

Blood sugar changes

Blood sugar changes could explain the anxiety some people experience on semaglutide. Animal studies indicate that unstable blood sugar levels impact brain chemistry and stress pathways, which in turn influence mood.

Because semaglutide can lower blood sugar, some people notice changes in how they feel as their body adjusts. In studies with diabetic mice, semaglutide actually reduced anxiety-like behaviors. 

Blood sugar changes are one possible explanation, but further research in humans is needed to confirm this.

Rapid weight loss stress

Some people taking semaglutide lose weight fairly quickly, and that shift can bring emotional changes along with the physical ones. Research in other areas, like bariatric surgery and even studies of athletes who undergo rapid weight loss, suggests that adjusting to changes in the body, new routines, and changes in eating affects mood.

While there aren’t clear studies directly linking semaglutide-related weight loss to anxiety, some people have shared personal stories online about feeling more anxious or even experiencing panic attacks during their weight-loss journey.

These accounts don't prove cause and effect, but they do show that rapid body changes feel stressful for some people.

Nausea and physical discomfort

Stomach upset is one of the most common side effects reported by people taking semaglutide. Some experience nausea, while others deal with symptoms like vomiting, stomach pain, constipation, or diarrhea. For most, these side effects ease over time, but when they linger, they can feel draining.

Feeling sick day after day can make it hard to relax or focus, and could possibly contribute to stress or anxious feelings. While there isn’t strong evidence that nausea directly causes anxiety, it’s easy to see how persistent discomfort could affect your mood.

Panic attacks are not a common side effect of semaglutide. However, there have been scattered reports of people experiencing panic-like symptoms after starting the medication.

In one firsthand account, a person described experiencing severe chest pain during the first month of treatment and called paramedics to rule out a heart attack. After testing showed no heart issues, their clinician suggested the symptoms were likely related to a panic attack, based on their mental health history.

Keep in mind that symptoms such as headaches, dizziness, or fatigue can also be side effects of semaglutide itself. These physical sensations may feel alarming and, in some cases, could be mistaken for or contribute to panic. Because side effects and anxiety can overlap, it isn’t always easy to tell them apart without medical guidance.

So far, research hasn’t shown panic attacks to be a direct or common effect of semaglutide, but a small number of people have reported them.

If you notice anxious feelings while taking semaglutide, here are a few steps that can help. Remember, these are general strategies, not a substitute for medical care.

• Track your symptoms: Keep a simple log of when anxiety shows up and what else is happening (such as dose changes, meals, or sleep). This can make it easier to notice patterns.

• Support your body: Regular meals, good sleep, hydration, and light activity like walking or stretching can ease side effects and stress. Studies show these simple habits can help reduce symptoms of anxiety and improve mood.

• Practice calming routines: Breathing exercises can reduce feelings of anxiety.

• Talk it over: Share what you’re experiencing with a healthcare provider. They can help rule out other causes and decide if your medication plan needs adjusting.

• Lean on support: Friends, family, or support groups can be a good outlet for talking about both the physical and emotional parts of the treatment journey.

While there’s no one-size-fits-all approach, paying attention to how you feel and seeking guidance early can make the process easier to manage.

While occasional stress or worry are normal, if anxious feelings become frequent, feel overwhelming, or interfere with daily life, it’s important to reach out to a healthcare provider.

You should seek help if you have:

• Ongoing anxious thoughts that are hard to control or feel overwhelming.

• Physical symptoms like a pounding heartbeat, unexplained aches, or trouble sleeping.

• Changes in behavior, such as avoiding activities or social situations you usually enjoy.

Anxiety disorders are common and treatable, but many people don’t realize support is available.

A provider can help you explore options, which may include therapy, lifestyle changes, or medications when needed. Family or close friends can also play an important role in offering support and encouraging you to make the best choice for your wellbeing.

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While anxiety is not considered one of the main side effects of semaglutide, a small number of people have reported it. Does that mean Semaglutide can cause anxiety? The research doesn't show a strong link, but a few things may help explain why it happens to some:

• Physical factors may play a role: Shifts in blood sugar, rapid weight loss, and common side effects like nausea or stomach discomfort could all contribute to feelings of unease or anxiety in certain people.

• Panic attacks are rare but reported: A few accounts describe panic-like symptoms, though these are not considered typical effects of the medication. Since some side effects feel similar to anxiety symptoms, it can be tough to know which is which.

• Seek support if needed: If anxiety becomes persistent, distressing, or affects daily life, it’s important to talk with a healthcare provider before making any changes to your treatment.