Which Medicines Can Cause Severe Depression? Wegovy-Ozempic?

Most people experience sadness or depression sometime during their lives. Divorce, the death of a loved one, work-related problems or financial setbacks can all trigger severe depression. Once the crisis is over, though, most people recover their equilibrium. Other people, though, suffer severe depression for no apparent reason. Sometimes antidepressant medication helps, but not always. Rarely do health professionals consider the possibility that drugs they have prescribed might be causing psychological distress. One of the hottest drugs in the pharmacy, semaglutide (Ozempic, Wegovy) is now being questioned.

When Drugs Cause Severe Depression:

Drug side effects pose a dilemma for doctors. On the one hand they are encouraged to “first do no harm.” But all medications have the potential to cause complications.

It is neither practical nor desirable to warn patients about every potential adverse reaction. That’s why physicians have to be selective in choosing which information they share with patients.

Research suggests, however, that health professionals may need to be more attentive to an often-ignored drug side effect: severe depression.

Hundreds of Meds Can Trigger Depression:

Investigators analyzed data from more than 26,000 adults who participated in the National Health and Nutrition Examination Survey between 2005 and 2014 (JAMA, June 12, 2018). The volunteers filled out questionnaires designed to reveal depression and also answered detailed questions about medication use within the preceding month.

As part of the analysis, the researchers used a pharmaceutical database to identify medicines that have depression, suicide or suicidal thoughts listed as common or serious complications. Statistical analyses determined any association between the score on the depression questionnaire and the pharmaceuticals people were taking.

Scary Results: Severe Drug-Induced Depression

The results were shocking. Approximately seven percent of the people taking just one drug that could trigger depression reported mood disorders. Over 15 percent of those who were taking three or more drugs with this possible side effect experienced depression.

The authors note that:

“Adults in the United States reported use of more than 200 medications that have been associated with depression or suicidal symptoms as adverse effects.”

You might be surprised to learn that some of the most common include blood pressure medicines, acid-suppressing drugs, pain relievers and birth control pills.

What About Semaglutide (Ozempic, Wegovy) and Depression?

Semaglutide has turned into one of the most successful drugs in recent memory. Social media helped make it THE drug for weight loss. You can read about the three brands of semaglutide: injectable Ozempic (for type 2 diabetes), injectable Wegovy (for weight loss) and oral Rybelsus (for type 2 diabetes) at this link. It appears that injectable semaglutide remains “currently in shortage” according to the FDA. That’s because it is so popular.

What about psychological side effects? We started hearing whispers about depression and/or suicidal thoughts back in August. That is when NBC News asked:

“Should Ozempic come with a warning about a risk of suicidal thoughts?”

The lead paragraph stated:

“Following reports of self-injury and suicidal thoughts among a small number of people who’ve taken Ozempic or Wegovy in Europe and the United Kingdom, health regulators there are investigating whether the drugs carry a risk of these side effects.”

According to the author, Aria Bendix, the EMA (European Medicines Agency) was reviewing 150 reports reports of potentially serious psychological side effects.

Ozempic has no warning about either depression or suicidal ideation in the official prescribing information. Wegovy, on the other hand has this warning:

” • Suicidal Behavior and Ideation: Monitor for depression or suicidal thoughts. Discontinue WEGOVY if symptoms develop.”

There is a whole section in the prescribing information:

“Suicidal Behavior and Ideation

“Suicidal behavior and ideation have been reported in clinical trials with other weight management products. Monitor patients treated with WEGOVY for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Discontinue WEGOVY in patients who experience suicidal thoughts or behaviors. Avoid WEGOVY in patients with a history of suicidal attempts or active suicidal ideation.”

NPR Reports on Possible Mental Health Side Effects (Sept. 21, 2023):

You can listen or read a report by Sydney Lupkin about Ozempic on All Things Considered at this link .

She describes the case of Jenny Kent who developed mental health problems while on this drug for type 2 diabetes:

“I was just constantly in a state of being overwhelmed,” says Kent. “So my response to that was just I was just crying all the time. Sobbing, crying … I still didn’t put it together, so I kept … taking my injections.”

Sydney goes on to describe the EMA’s investigation into 150 reports of suicidal thoughts associated with semaglutide.

According to Ms. Lupkin:

“The FDA hasn’t taken that step. For now, the agency is monitoring the situation. ‘We continue to conclude that the benefits of these medications outweigh their risks when they are used according to the FDA approved labeling,’ spokesperson Chanapa Tantibanchachai said in an email to NPR. She noted that weight-loss drug Wegovy, which contains the same active ingredient as Ozempic, semaglutide, includes a warning about suicidal thoughts on its label.”

Sydney Lupkin goes on to describe an NPR analysis of the FDA’s adverse event reporting system (FAERS). It has apparently received nearly 500 voluntary reports of psychological side effects associated with semaglutide.

We won’t know if this drug for type 2 diabetes and weight loss really causes psychological depression or suicidal thoughts until a well-controlled clinical trial is conducted. At the moment, all we could find in the medical literature was a report of two cases of “semaglutide-associated depression” published in the journal Frontiers in Psychiatry (Aug. 29, 2023).

Here is the summary:

“One is a middle-aged man with no previous history of depression who developed depressive symptoms about 1 month after taking semaglutide. The other one is a middle-aged woman with recurrent depressive disorder whose symptoms also recurred about 1 month after semaglutide treatment. Depression was improved or relieved after discontinuation of semaglutide in both cases. Possible psychiatric adverse effects of depression should be taken into consideration when semaglutide is administered to patients.”

Over-The-Counter Drugs and Depression:

Most of these drugs are prescribed, but some are available over the counter. Proton pump inhibitors, for example, such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) may all trigger symptoms of depression.

So can the emergency contraceptive levonorgestrel (Plan B). Unfortunately, OTC drug labels contain little information about depression as a side effect.

Are Patients Informed About Drug-Induced Depression?

Even when people take prescription medicines, they may not get information about side effects.

One reader wrote:

“I took the beta blocker propranolol a couple of years ago to slow my heart rate down. The medication worked, but after a week or so I started to sleep more, wanted to be alone and lost interest in cooking and eating.

“I work from home and my job is challenging and exciting. However, after few weeks I didn’t care if there were orders to process and I didn’t want to communicate with customers. I had to force myself to do things that normally I can’t wait to wake up and start my day doing.

“After six months I was really depressed. I spoke to my cardiologist’s nurse, but she said that depression was highly unlikely as a side effect. She said I could safely stop taking propranolol because I was on a very small dose. I skipped a pill for a day and felt like a dark cloud started to lift. I felt happy.

“When I went to my cardiologist and told him what had happened, he said that depression is a very common side effect of beta blockers. Really? Why was that too hard to mention before he put me on it?”

Commonly Taken Meds and Depression:

An NPR report (June 12, 2018) describes it this way:

“The list includes a wide range of commonly taken medications. Among them are certain types of proton pump inhibitors (used to treat acid reflux), beta blockers, anxiety drugs, painkillers including ibuprofen, ACE inhibitors (used to treat high blood pressure) and anti-convulsant drugs.

“’The more of these medications you’re taking, the more likely you are to report depression,’ says study author Mark Olfson, a professor of psychiatry at Columbia University.”

Drugs The Investigators Looked At:

There are hundreds of medications that can affect the mood. Some of the drugs that were on the investigators list included:

No one should ever stop any medicine without careful consultation with the prescriber. Some of these drugs are absolutely essential and it may not be appropriate to stop, even if depression is a side effect. That said, let your physician know if you experience severe depression as a side effect. An alternative medication may be feasible.

A Close Call with Heartburn Medicine:

Many years ago a reader shared this experience:

“I was stopped at an intersection on an icy day waiting for a sand truck to pass when I almost pulled out in front of him–intentionally.

“When I saw the young man’s face, I said to myself, ‘I cannot do this to him.’ After the truck passed and I drove on, I wondered what in the world was going on. I was not depressed.

“When I arrived home, I was still shaken from what I had almost done. I read the daily newspaper while I ate lunch. The first article in your column that day was from a lady whose husband had committed suicide while taking metoclopramide (Reglan).

“That was the exact same medication my doctor had prescribed for my stomach. I jumped up and emptied that bottle down the toilet and wrote on it in large letters, DO NOT TAKE AGAIN. I thank God and the lady who wrote you that letter.”

Metoclopramide carries a warning that it can cause mental depression and suicidal ideation. Patients should always be cautioned about such a serious complication.

Sometimes a medicine is essential, and any psychological reactions it causes can be handled with another medication. But often, rather than piling one drug with potential side effects up on top of another, it makes sense to re-evaluate the original treatment.

Full Information About Drugs and Severe Depression!

Health professionals must alert their patients about the potential for drug-induced severe depression as a side effect. This is particularly true if people are taking more than one medication.

Please share your own experience with drugs and depression in the comment section below. You may find our free eGuide “Psychological Side Effects” of interest. It can be downloaded from the Health eGuides section of this website. There is also an eGuide to Dealing with Depression.