Worry about mood on a GLP-1 is common, and for a while the labels gave it a reason. The weight-loss versions, Wegovy, Zepbound and Saxenda, carried a warning about suicidal thoughts and behavior. On January 13, 2026, FDA said its review "found no increased risk" and asked for that warning to be removed [1]. This page covers what FDA looked at, what the labels say now, and the mood symptoms that still deserve attention.
FDA found no increased risk of depression, anxiety or suicidal thoughts
FDA's Drug Safety Communication is direct. It reports that a comprehensive review "found no increased risk of SI/B," short for suicidal ideation and behavior, with GLP-1 receptor agonists. Its pooled analysis also "did not show an increased risk" for "other relevant psychiatric adverse events such as anxiety, depression, irritability, or psychosis" [1].
The question had been open since July 2023, when FDA started looking into reports of suicidal thoughts from people taking these drugs. A first review, published on January 30, 2024, found no link in the trials, but there were so few cases in each trial that the estimate was uncertain [1]. The 2026 review was built to settle that uncertainty.
The review covered 91 trials and more than 2 million people
FDA used two kinds of evidence. The first was a meta-analysis of 91 placebo-controlled trials across the GLP-1 drug programs: 107,910 people, of whom 60,338 took a GLP-1 drug and 47,572 took placebo. Because every trial had a placebo group, this part compares like with like [1].
The second was a claims-data study in FDA's Sentinel System. It followed 2,243,138 people with type 2 diabetes who started either a GLP-1 drug (1,161,983 people) or an SGLT2 inhibitor, another class of diabetes pills (1,081,155 people), between October 1, 2015, and September 20, 2023. After adjusting for differences between the groups, FDA found no increased risk of intentional self-harm with GLP-1 drugs, including in people who had both diabetes and obesity [1].
FDA also reviewed published observational studies and concluded that, taken together, they "do not support a causal relationship" between GLP-1 drugs and suicidal thoughts or behavior [1]. That's three separate lines of evidence pointing the same way.
Why pool so many trials? Suicidal thoughts are rare in any single trial, so one study can't tell a real difference from chance. Pooling 91 of them gives enough events to measure the risk with far more precision, which was the gap FDA said its 2024 review left open [1]. The claims study adds something trials can't: millions of people treated in everyday care, compared with people starting a different diabetes medicine.
The Wegovy and Zepbound labels dropped the warning in February 2026
The warning had been on these labels since their first approvals. FDA says the language "is based on reports of such events observed with a variety of older medicines used or studied for weight loss" [1]. The current Zepbound and Wegovy labels list "Suicidal Behavior and Ideation" as removed in February 2026 [2] [3].
| Drug | Approved for | Carried the warning? | Now |
|---|---|---|---|
| Zepbound (tirzepatide) | Weight reduction; sleep apnea with obesity | Yes | Removed February 2026 |
| Wegovy (semaglutide) | Weight reduction; heart risk reduction; MASH | Yes | Removed February 2026 |
| Saxenda (liraglutide) | Weight reduction | Yes | FDA requested removal |
| Ozempic (semaglutide) | Type 2 diabetes | No | No warning |
| Mounjaro (tirzepatide) | Type 2 diabetes | No | No warning |
FDA Drug Safety Communication, January 13, 2026 [1]; Zepbound and Wegovy prescribing information, Recent Major Changes [2] [3].
Ozempic and Mounjaro never had the warning. FDA notes that labels for GLP-1 drugs approved for blood sugar control in type 2 diabetes "does not currently include information on the risk of SI/B," and that its action makes the message consistent across all approved GLP-1 drugs [1]. A search of the current Ozempic and Mounjaro labels finds no depression or anxiety entry outside the low-blood-sugar symptom list [4] [5].
Anxiety can still be a sign of low blood sugar
One place anxiety does appear on these labels is in the list of low blood sugar symptoms. The patient guides for Zepbound, Mounjaro and Ozempic all list "anxiety, irritability, or mood changes" next to sweating, shakiness, hunger and a fast heartbeat [2] [5] [4]. Wegovy's guide lists anxiety and "irritability or mood changes" among the same symptoms [3].
Zepbound's patient guide says the risk of low blood sugar may be higher if you also take a medicine that lowers it, such as insulin or a sulfonylurea [2]. So if you feel suddenly anxious or irritable along with shakiness or sweating, that pattern points to blood sugar, and it's worth telling your prescriber about.
Tiredness is another "feeling off" symptom that is on the labels. In Zepbound's weight trials, fatigue was reported by 5% to 7% of people across doses vs 3% on placebo [2]. More on that in does Zepbound make you tired? and does Wegovy make you tired?
When to call your prescriber
FDA's advice for patients didn't change with the review. It tells people to keep taking their medicine as prescribed and to raise any concerns with their clinician [1]. Its patient guidance reads:
Tell your health care professional if you experience new or worsening depression, suicidal thoughts, or any unusual changes in mood or behavior. Call or text 988 … which provides free support for people in distress 24 hours a day, 7 days a week.[1]
A finding of no increased risk across large groups can't speak for every single person, which is why FDA keeps the advice to report any change, whatever the cause. For the wider safety picture, see is Wegovy safe?, Zepbound side effects and tirzepatide side effects.
Metformin's label has no mood entry either
If you take metformin alongside a GLP-1 or instead of one, its label lists no depression or anxiety side effect [6]. Its common side effects are stomach-related; see metformin side effects.
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