Trends in Reporting of Psychiatric Adverse Events Including Suicidal Ideation for GLP-1 Receptor Agonists

Numerous glucagon-like peptide 1 (GLP-1) receptor agonists, such as liraglutide, semaglutide, and tirzepatide, have been developed to prolong the activity of GLP-1 and resist degradation by dipeptidyl peptidase 4 (DPP4) thus leading to sustained glycemic control and weight loss. The objective of this study is to characterize trends in reporting of overall adverse events, psychiatric adverse events, and suicidal ideation for the three GLP-1 receptor agonists liraglutide, semaglutide, and tirzepatide. The U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) contains all submitted reports of adverse events associated with prescription and over-the-counter pharmaceuticals in the United States. The FAERS database was searched using the search terms tirzepatide, semaglutide, and liraglutide for the years 2010 to 2025. The number of adverse events for GLP-1 receptor agonists has increased exponentially since 2021, however there were differences in reporting trends between the 3 drugs studied, with increased adverse effects reported for semaglutide and tirzepatide but not for liraglutide. This corresponds to increased numbers of practitioners using semaglutide and tirzepatide compared to liraglutide. The number of psychiatric adverse events were highest for semaglutide followed by tirzepatide and liraglutide. The percentage of reported adverse events involving suicidal ideation for liraglutide peaked in 2023, where the percentage for liraglutide was 1.69 times greater than the percentage for semaglutide, and 13 times greater than the percentage for tirzepatide. Because suicidal ideation is such a serious adverse event, further research into this effect of these GLP-1 receptor agonists is needed.