Does Ozempic cause depression?

Ozempic (semaglutide) is known for its ability to lower blood sugar levels, cardiovascular risk, and body weight. The once-weekly injectable medication is FDA-approved to treat type 2 diabetes, but it may also be prescribed off-label for weight loss. 

In clinical trials, the most common side effects of Ozempic included nausea, vomiting and diarrhea. However, recent anecdotal reports of depression on social media have raised concerns. (At the same time, other social media users have reported a lift in mood and a reduction in anxiety and insomnia after starting Ozempic and similar medications.)

So, does Ozempic cause depression? Read on as we explore the link between Ozempic and depression.

Some people have reported depressive symptoms while taking Ozempic and other GLP-1 medications, such as Wegovy. However, according to the FDA, a preliminary evaluation of the current research does not suggest a direct, causal link between Ozempic and depression. In fact, some studies suggest that Ozempic may even relieve symptoms of depression. For example:

• People with type 2 diabetes (but not diagnosed depression) report significantly fewer symptoms of depression after beginning treatment with GLP-1 medications, including Ozempic. These findings are based on a meta-analysis of five randomized controlled trials and a prospective cohort study with a total of over 2,000 participants.

• People both with and without type 2 diabetes are less likely to be diagnosed with depression or anxiety after starting GLP-1 medications, according to an analysis of over 4,000,000 patients. However, it’s important to note that these findings were based on health insurance data and not published in a peer-reviewed journal. Furthermore, confounding factors such as the motivation to start taking the medication in the first place could affect these results and were not controlled for.

• One study found that people both with and without type 2 diabetes are also significantly less likely to report having suicidal thoughts, either on a one-off or ongoing basis, after starting treatment with semaglutide (the active ingredient in Ozempic and Wegovy). These findings are also based on electronic health records and were published in a peer-reviewed journal.

Despite these positive findings for Ozempic, it’s worth noting that some GLP-1 medications—the class of drugs to which Ozempic belongs—have reported depression and suicidal thoughts in their clinical trials. Specifically, both Saxenda (liraglutide) and Wegovy (semaglutide) include depression and suicidal behavior or thoughts as warnings on their prescribing information. The FDA also recommends that healthcare providers monitor all patients on GLP-1 medications during their treatment for changes in mood, suicidal thoughts, and new or worsening depression. However, Ozempic does not have these same warnings on the drug label at the time of writing. 

“There have been some people reporting depression, or depressive symptoms, who take Ozempic, but it's important to note that there is no direct evidence that Ozempic causes depression,” shared Dr. Rachel Goldman, PhD, FTOS, FASMBS-IH, Licensed Psychologist and Clinical Assistant Professor at NYU Grossman School of Medicine. “Depression is not listed as a ‘common side effect’ on the FDA drug label for Ozempic, although it is listed as one on the label for  Wegovy [another GLP-1 medication which contains the same active ingredient as Ozempic, but in higher dosage strengths.]”

While the current research doesn’t suggest that Ozempic makes you depressed, that doesn’t “definitively rule out that a small risk may exist,” the FDA says. Currently, the FDA has not found a causal relationship between taking GLP-1s like Ozempic and suicidal thoughts. But, since a small number of people did experience these symptoms in clinical trials, the FDA’s research is ongoing. 

Researchers are still learning more about how these medications work, and their impact on the brain. “It's difficult to isolate a situation and say X causes Y without proper research and clinical trials. People take multiple medications and supplements, [and] do different things,” shared Dr. Goldman. “Therefore, it is difficult to say that Ozempic directly causes depression. Could those who feel like they are now experiencing depressive symptoms after taking Ozempic have developed, or experienced, these symptoms even without taking Ozempic? It's possible.”

The research done to date has yet to find a direct link between Ozempic and depression. So what could explain the symptoms people are reporting? For one, the GLP-1 agonists help reduce food cravings by modifying “hedonic tone,” which means you experience less pleasure when you eat those foods. This mechanism could in theory spill over and affect your enjoyment of other things. However, there hasn’t yet been a proven causative relationship between GLP-1 agonists and depression and it’s important to remember that some studies have even found GLP-1 agonists have actually reduced depression in both animals and humans.

There could be a few other factors at work, too, starting with the two underlying conditions that Ozempic may be prescribed to treat: diabetes and obesity. 

Research has shown that people with type 2 diabetes may be approximately twice as likely to experience major depression than people without type 2 diabetes. Additionally, people with obesity are 55% more likely to become depressed, while people with depression are 58% more likely to develop obesity. 

Depression can cause symptoms that influence your appetite, energy and motivation—all of which can make you more vulnerable to weight gain. Some types of depression may lead to oversleeping, fatigue, and overeating, which in turn can lead to weight gain. And, some (but not all) of the medical treatments for depression, including many antidepressants, can cause weight gain as a side effect. 

Depression is also fairly common with nearly one in 10 Americans reporting a major depressive episode within the last year. Given how common depression is, and given its link with diabetes and obesity, it’s possible that in some cases, the connection between Ozempic and depression could be one of correlation, not causation. “There are so many factors that could contribute to someone experiencing depressive symptoms” shared Dr. Goldman. “When I work with clients and they experience new symptoms, I like to take time to assess what else has changed. What could be the potential cause? Sometimes it's other things in their life, like a major change or stressor, and it was just a coincidence that they also started that medication at that time.”

People’s expectations of Ozempic may also play a role, she suggested. “Like anything, people can become sad, and even depressed, when their expectations don't meet reality. I have had some clients feel really down about the fact that they aren't losing the amount of weight they had hoped, or expected to, as quickly—especially in the first few weeks when people's bodies are first getting used to the medication and they are on such a low dose. Weight is complicated, and for many people who have been trying to lose weight for years, [they] are used to diets not working.”

“When you hear of so many people being successful on GLP-1s, we need to remember that we don't know their whole story and we can’t compare,” shared Dr. Goldman, emphasizing the importance of maintaining realistic expectations when using the medications. 

Overall, any number of factors could contribute to a person experiencing depressive symptoms, whether or not they are taking Ozempic. 

In its simplest terms, depression is characterized by a persistent feeling of sadness and a loss of interest in things or activities you previously found enjoyable. Other signs of depression can include:

• Sleep issues

• A reduction in interest and pleasure

• Feelings of guilt or worthlessness

• Fatigue or changes in energy

• Issues with concentration or paying attention

• Changes in weight or appetite

• Suicidal thoughts

If you start to notice these signs, reach out to a healthcare provider. Experts estimate nearly 60% of people with depression do not seek help, even though treatment can be very effective. Treatment for depression usually involves a mix of lifestyle changes, therapy, and medication and can vary depending on the specific symptoms you are facing. Your healthcare provider can help you find an effective treatment plan for you. 

If you or someone you care about is having suicidal thoughts or thinking about self-harm, it’s important to get help right away. You can call the National Suicide Prevention & Mental Health Crisis Lifeline at 1-800-273-8255, which is available 24/7 at no cost. Alternatively, you can dial 988 to reach the same lifeline. This service is there to offer support and connect you with local resources to assist during a mental health crisis.

“If anyone ever starts feeling depressed, or experiencing depressive symptoms, that's a sign to seek professional help,” said Dr. Goldman. “I would recommend you first share this with your prescribing provider and try to properly assess the situation in terms of when it started, and what are the symptoms you are experiencing.” 

“If you are having thoughts of harming yourself or someone else, immediately call 911 (or 988—the National Suicide Prevention & Mental Health Crisis Lifeline) or go to your local emergency department,” she said. 

During your appointment, your healthcare provider will help you try to understand what could be behind your symptoms. Do not stop taking Ozempic before talking to your healthcare provider first, the FDA warns. Stopping these medications without professional guidance can cause unwanted symptoms and may make things worse.

Whether Ozempic is a good fit is a decision that is made on an individual basis, whether or not you already have depression. “This is a question for you to discuss with your healthcare team, which includes your mental health professional, assuming you are going to one,” said Dr. Goldman. 

“Generally speaking, I would not say that you ‘should not’ take Ozempic if you have depression, but if this was my patient, I would want to have a team discussion with their healthcare team(including the patient) and most likely have more regular follow up appointments to be able to assess the impact that Ozempic has on them.”

People both with and without depression take Ozempic. If you find that your symptoms are getting worse, or you’re noticing new ones, talk to your healthcare provider.

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Current version

July 30, 2024

Written by

Amelia Willson

Fact checked by

Raagini Yedidi, MD

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About the medical reviewer

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.