There have so far been 150 reports of possible cases of self-harm and suicidal thoughts. The European Medicines Agency (EMA) is now investigating whether the active ingredients in the drugs could actually lead to depression or suicidal behavior. There is currently no causal connection. David Infanger, a specialist in obesity, provides information on the latest developments.
SRF News: How do you classify a possible causal connection between taking Ozempic and reports of depression and suicidal thoughts?
David Infanger: A causal relationship is difficult to assess and there is still no solid literature on it. There is a study on the drug Saxenda. The proportion of those treated who had thoughts about suicide was 0.3 percent – compared to 0.1 percent in the placebo group.
However, the treated group also lost more weight than the untreated group. However, based on current studies, it cannot be proven whether this has an impact on emotional eating behavior.
What does that mean?
I can imagine that emotional eating behavior disappears due to the suppressed feeling of hunger and that this can lead to problems for susceptible people. Therefore, these medications for the treatment of diabetes or weight loss may only be dispensed as part of an obesity or diabetes program. As part of this, regular medical checks are carried out, where the psychological situation is also recorded and, if necessary, therapy can be stopped at an early stage.
But there are also other studies that suggest that GLP-1 agonists can have a beneficial effect on depression.
Are there any proven long-term effects from taking the medication?
When taken over a period of five to ten years, there are studies that document side effects such as diarrhea, constipation and vomiting. However, there is still no long-term study over 20 to 40 years because the substance group has not been around in therapy for that long.
The Saxenda drug for the treatment of overweight people is usually paid for by the health insurance company for three years and then stopped and only prescribed at intervals. Ozempic is used for a long time in diabetics because it is a diabetes medication.
People with a body mass index below 27 should not use Ozempic for weight loss because the risk-benefit ratio is not met.
But you always have to weigh up the advantages and possible dangers. A severely overweight person who loses 10 kilograms or more is significantly less likely to have certain cancers and has better cholesterol and blood pressure levels. That means the benefits of weight loss outweigh the potential risks. People with a body mass index below 27 should not use Ozempic for weight loss because the risk-benefit ratio is not met and there are already supply shortages, meaning diabetics cannot receive adequate care.
The results of the review of the 150 reports are expected at the end of November 2023. What happens if a causal relationship can be established?
Depending on the connection established, the target group would have to be restricted or the drug would have to be taken off the market. Depending on the situation, it would also be a decision for the entire group of substances. Many people have permanently lost weight thanks to this group of medications – it would be a tragedy if this group of substances could no longer be given.
The interview was conducted by Saya Bausch.