Weight Loss · Reference
GLP-1s, Anxiety and Depression: Can Tirzepatide or Semaglutide Affect Your Mood?
This page sets out what has been studied, what has not, the physical effects that are easy to mistake for anxiety, and what to do if your mood changes.
Treatments mentioned
If you are in crisis or thinking about harming yourself, call or text 988 in the US, or call 911, now.
The current evidence does not show that semaglutide causes depression or suicidal thoughts, and Pepti's references do not describe anxiety or depression as a side effect of tirzepatide. Reports of suicidal thoughts on GLP-1 medications led to regulatory reviews in 2023; since then a large 2024 study in Nature Medicine reported lower rates of suicidal thoughts on semaglutide than on other weight-management drugs, and the suicidal-behavior warning on the approved semaglutide weight-management label was removed in February 2026. Some common side effects, such as dizziness, fatigue and the shakiness of low blood sugar, can feel like anxiety. Any change in your mood on any medication is worth a message to your care team.
This page sets out what has been studied, what has not, the physical effects that are easy to mistake for anxiety, and what to do if your mood changes.
GLP-1s, Anxiety and Depression
The short answer
| Question | Answer |
|---|---|
| Does semaglutide cause depression? | Current evidence does not support it |
| Does semaglutide cause suicidal thoughts? | A 2024 cohort of over 240,000 people reported lower rates on semaglutide than on other weight-management drugs |
| Can tirzepatide cause anxiety? | Pepti's references describe no tirzepatide-specific mood study and do not list anxiety among its common side effects |
| Can side effects feel like anxiety? | Yes: dizziness, fatigue, low blood pressure and low blood sugar symptoms can overlap with how anxiety feels |
| Should I report a mood change? | Yes, always, on any medication |
| Should I stop my antidepressant to help a GLP-1 work? | No. Never stop a psychiatric medication on your own |
| In crisis? | Call or text 988, or call 911 |
The GLP-1 medications Pepti prescribes:
| Medication | How it acts | Price |
|---|---|---|
| Semaglutide | GLP-1 receptor; once-weekly injection from dose-specific vials | From $99/mo |
| Tirzepatide | GIP and GLP-1 receptors; once-weekly injection from dose-specific 2 mL vials | From $159/mo |
Prices are "from" prices and all-in, covering medication, physician review, refill management and shipping. Compounded medications are not FDA approved.
GLP-1s, Anxiety and Depression
What has been studied: semaglutide and suicidal thoughts
The 2023 reviews
Reports of suicidal thoughts in people taking GLP-1 medications prompted regulatory reviews in 2023. That is where most of the worry people search about comes from.
The 2024 cohort study
A large electronic-health-record cohort published in Nature Medicine in 2024 covered 240,618 people with overweight or obesity. It reported a lower rate of new suicidal ideation on semaglutide than on other weight-management drugs (hazard ratio 0.27), and the finding was replicated in 1.59 million people with type 2 diabetes. A cohort study shows association, not cause, so the fair reading is that it found no sign of the harm people feared, rather than proof of a protective effect.
The 2026 label change
The approved semaglutide weight-management label had carried a Suicidal Behavior and Ideation warning, carried over from older weight-management products. It was removed in the February 2026 revision.
Year What happened 2023 Reports of suicidal thoughts on GLP-1 drugs prompted regulatory reviews 2024 Nature Medicine cohort of 240,618 people reported lower suicidal ideation rates on semaglutide than on other weight-management drugs February 2026 The suicidal-behavior warning was removed from the approved semaglutide weight-management label None of that makes mood irrelevant. Any change should still be reported, and a history of depression is part of the intake for a reason.
GLP-1s, Anxiety and Depression
What has not been studied: tirzepatide and anxiety
People search "can tirzepatide cause anxiety" more than almost any other mood question, and the honest answer is limited. Pepti's tirzepatide references summarize the label's reported side effects, and anxiety and depression are not among them. Those references describe no tirzepatide-specific study of anxiety, depression or suicidal thoughts. That is an absence of evidence in Pepti's sources, not proof that tirzepatide never affects mood, and this page does not claim either.
What the tirzepatide label does list includes several physical effects that can feel like anxiety, covered next.
GLP-1s, Anxiety and Depression
Side effects that can feel like anxiety
Shakiness, sweating, a racing heart, light-headedness and feeling unwell in the stomach are also how many people describe anxiety. Some GLP-1 side effects produce exactly those sensations.
| What you feel | A possible GLP-1 cause | What the labels report |
|---|---|---|
| Shakiness, sweating, confusion | Low blood sugar | Mainly with insulin or a sulfonylurea; tirzepatide's label notes it has also been reported in adults without diabetes |
| Dizziness, light-headedness on standing | Low blood pressure or dehydration | Low blood pressure 1.6% on tirzepatide against 0.1% on placebo; dizziness 4 to 5% against 2% |
| Tiredness, low energy | Eating and drinking too little | Fatigue 5 to 7% on tirzepatide against 3% on placebo |
| A faster resting heart rate, palpitations | Heart rate increase | The semaglutide label reports a mean rise of 1 to 4 beats per minute and asks that palpitations at rest be reported |
| Queasiness, a knotted stomach | Slower stomach emptying | Nausea is the most common GLP-1 side effect, worst after starting and after each increase |
These overlap with anxiety, which is why describing exactly what you feel, and when, helps your care team tell them apart. Low blood sugar in particular needs treating first and reporting after. The full side-effect lists are in tirzepatide side effects and semaglutide side effects.
GLP-1s, Anxiety and Depression
Antidepressants, mood and weight
Two practical points come up for people who already take medication for anxiety or depression.
First, several antidepressants and antipsychotics are described in reviews (Gastroenterology Clinics of North America, 2023; Endocrinology and Metabolism Clinics of North America, 2020) as promoting weight gain. That can be part of why weight is hard to shift. It is never a reason to stop a psychiatric medication on your own. Bring the full list to your prescribers. More is in not losing weight on a GLP-1.
Second, a GLP-1 slows stomach emptying, which can change how quickly some oral medications are absorbed, mostly in the first weeks after starting or increasing the dose. List every medication you take on the intake so your physician can review them together.
An active eating disorder is a situation where a GLP-1 is usually avoided, because appetite suppression interacts badly with restrictive patterns. If that applies to you, say so on the intake.
GLP-1s, Anxiety and Depression
When to message your care team, and when to get help now
| Situation | What to do |
|---|---|
| Thoughts of harming yourself, or of suicide | Call or text 988 in the US, or call 911, now |
| Shakiness, sweating and confusion, especially on insulin or a sulfonylurea | Treat low blood sugar, then report it |
| Swelling of the face or throat, or trouble breathing | Call 911 |
| A new low mood, anxiety or irritability that is not lifting | Message your care team |
| Palpitations at rest | Message your care team |
| Dizziness on standing, dark urine, not keeping fluids down | Contact your care team the same day |
| Not eating enough because you have no appetite | Message your care team |
Your care team is reachable through your account at no extra cost. Never change, skip or double a dose on your own because of how you feel; your physician sets your directions after reviewing your intake and how you are doing, and any change is printed on your next vial. If your other prescriber is managing your mood, tell them you have started a GLP-1 too.
GLP-1s, Anxiety and Depression
What the evidence shows, honestly
For semaglutide, the best evidence on suicidal thoughts is reassuring: a very large cohort reported lower rates than on other weight-management drugs, and the label warning has been removed. It is observational, so it cannot prove cause in either direction. For tirzepatide, Pepti's references contain no mood-specific study, so there is nothing to report in either direction. Neither medication is a treatment for anxiety or depression, and nothing on this page suggests otherwise.
What is clear is practical: physical side effects can mimic anxiety, other medications matter, and a change in mood is always worth reporting. The broader safety pictures are in is semaglutide safe and is tirzepatide safe, and the class overview is in GLP-1 side effects.
GLP-1s, Anxiety and Depression
Where to get a GLP-1 prescribed
- Complete a free online intake covering your history, including mental health history, and every medication you take.
- A physician licensed in your state reviews it, usually within 24 hours.
- If it is appropriate, a PCAB-accredited, FDA-registered US 503A pharmacy compounds it to that prescription. Lot test results are published at /quality/lab-results.
- It ships refrigerated with ice packs, sterile syringes and alcohol prep pads, with your directions printed on the vial.
- Your care team stays reachable for side effects and mood changes. Refills run every 28 days, one vial per fill.
Pepti is cash-pay and does not bill insurance. Step-by-step pages: how to get semaglutide prescribed online and how to get tirzepatide prescribed online.
References
What this is based on.
References
- Wilding JPH, Batterham RL, Calanna S, et al.. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1) · New England Journal of Medicine (2021) · PMID 33567185
- Lincoff AM, Brown-Frandsen K, Colhoun HM, et al.. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT) · New England Journal of Medicine (2023) · PMID 37952131
- Wadden TA, Bailey TS, Billings LK, et al.. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity (STEP 3) · JAMA (2021) · PMID 33625476
- Rubino D, Abrahamsson N, Davies M, et al.. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial · JAMA (2021) · PMID 33755728
- Marso SP, Bain SC, Consoli A, et al.. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (SUSTAIN-6) · New England Journal of Medicine (2016) · PMID 27633186
- Davies M, Færch L, Jeppesen OK, et al.. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial · The Lancet (2021) · PMID 33667417
- Garvey WT, Batterham RL, Bhatta M, et al.. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial · Nature Medicine (2022) · PMID 36216945
- Rubino DM, Greenway FL, Khalid U, et al.. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial · JAMA (2022) · PMID 35015037
- Aronne LJ, Horn DB, le Roux CW, et al.. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5) · New England Journal of Medicine (2025) · PMID 40353578
- Sanyal AJ, Newsome PN, Kliers I, et al.. Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis (ESSENCE) · New England Journal of Medicine (2025) · PMID 40305708
- Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K et al.. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension · Diabetes Obes Metab (2022) · PMID 35441470
- Batsis JA, Gavras A, Gross DC, Cheever CR, Da Silva BR et al.. Effect of Incretin-Based and Nonpharmacologic Weight Loss on Body Composition: A Systematic Review · Ann Intern Med (2026) · PMID 41996180
Citations are provided for educational purposes. They do not constitute medical advice. Always discuss any peptide protocol with your prescribing physician.
Common questions
GLP-1s, Anxiety and Depression, answered.
Pepti's references do not list anxiety among tirzepatide's reported side effects and describe no tirzepatide-specific mood study. Some side effects, such as dizziness, fatigue and low blood sugar symptoms, can feel like anxiety. Report any change to your care team.
Pepti's references describe no evidence either way for tirzepatide specifically. A new or worsening low mood on any medication is worth a message to your care team, and thoughts of self-harm need 988 or 911 now.
Current evidence does not support it. A 2024 Nature Medicine cohort of over 240,000 people reported lower rates of suicidal ideation on semaglutide than on other weight-management drugs.
The evidence does not show that it does, and the approved weight-management label's suicidal-behavior warning was removed in February 2026. Any such thought should be acted on immediately: call or text 988, or call 911.
Reports of suicidal thoughts in people on GLP-1 drugs prompted regulatory reviews in 2023. The large studies and the label change since then are summarized above.
Antidepressants are not among the contraindications on the semaglutide or tirzepatide labels. List every medication on your intake so your physician can review them together. Never stop an antidepressant on your own.
It can be low blood sugar, especially with insulin or a sulfonylurea, or dizziness from low blood pressure or dehydration. Treat low blood sugar first, then tell your care team what happened.
Fatigue is a reported side effect, often tied to eating and drinking too little in the early weeks. If it is not easing, message your care team.
Neither semaglutide nor tirzepatide is a treatment for anxiety or depression, and this page makes no claim that they help. Mood support is a separate conversation with your own clinician; see peptides for anxiety and mood.
Message your care team rather than changing anything yourself. If you have thoughts of harming yourself, call or text 988, or call 911, now.
No. Bloodwork is not required for any Pepti treatment. If your physician wants labs for your care, they'll ask through your account. The free assessment goes to a physician licensed in your state. A consultation does not guarantee a prescription.
Next step
See what a physician recommends for you.
A licensed physician in your state reviews your intake and decides what is appropriate. A consultation does not guarantee a prescription.