Ozempic and your mood: does it cause depression?

What research and the patient information leaflet say about mood and depression

In July 2023, the European Medicines Agency (EMA) started a review of reports of low mood and suicidal thoughts in people using semaglutide and liraglutide. Its safety committee, PRAC, assessed clinical trials, post-marketing reports and two large studies based on patient records. The conclusion in April 2024: the available evidence does not support a causal link between GLP-1 receptor agonists and suicidal thoughts or self-harm. The product information did not need to be changed.

The reports themselves have been analysed. An analysis of the European adverse reaction database, published in the journal Pharmaceuticals, found 230 reports of suicidal events out of more than 41,000 reports about GLP-1 medications: 0.6 percent. Liraglutide and semaglutide were mentioned most often. The authors state that a report is not proof of cause and that further research was needed; the EMA carried out that research afterwards.

As for the patient information leaflet: depression and mood problems are not listed as side effects in the product information for Ozempic. Tiredness is, as a common side effect. People with severe depression or a history of suicidal thoughts were excluded from the large studies of semaglutide for overweight; extra caution and consultation with the doctor therefore apply to them.

What does Ozempic do to your hormones and brain?

Semaglutide mimics the gut hormone GLP-1 and acts on your pancreas, your stomach and your brain. In the pancreas, it stimulates the release of insulin when blood sugar rises. In the stomach, it slows gastric emptying. In the brain, it acts on the areas that regulate hunger, satiety and reward.

That last point is where the question about mood begins. Many users notice that constant thoughts about food disappear, and for most people that is a relief. For some, it also removes a source of comfort and pleasure; food was a way of dealing with stress or boredom. The medication does not change your personality, but it does change the role food plays in your day.

Ozempic affects other hormones mainly indirectly, through the weight loss. Losing weight improves insulin sensitivity, lowers markers of inflammation and can influence the menstrual cycle in women and testosterone in men. These changes are usually beneficial, but around the menopause they can also affect your energy and mood.

Indirect effects: less enjoyment of food, tiredness and social changes

Most mood complaints with Ozempic have an indirect cause: you eat less, you have less energy and your daily rhythm changes. According to apotheek.nl, the patient information website of the Dutch pharmacists' organisation KNMP, nausea and diarrhoea occur in 10 to 30 in 100 users, and tiredness and a general feeling of being unwell in 1 to 10 in 100.

Your social life changes too. Eating out, drinks and cooking together feel different when you are quickly full and have less appetite for alcohol. Partners and friends notice this and sometimes react to it. That is not a side effect of the medication, but it does influence how you feel.

Want to lose weight with a doctor who also asks how you feel? In a few minutes you will know whether medical weight loss could be right for you; the doctor then assesses your application. Eligibility check →

The difference between a dip and a signal to talk to your doctor

A dip in the first weeks is a known phenomenon: your body is getting used to eating less and to the side effects. A signal to talk to your doctor is a mood that stays low for longer than 2 weeks, or thoughts you did not have before. Contact your doctor or GP if you have:

• Low mood or emptiness that lasts longer than 2 weeks and does not improve as the side effects ease.
• No more pleasure in things you used to enjoy, apart from food.
• Anxiety or panic that is new or clearly getting worse.
• Sleep problems that last for weeks.
• Thoughts of self-harm or of not wanting to live any more. In that case, call your GP straight away, the out-of-hours GP service (huisartsenpost) or 113 Zelfmoordpreventie (the Dutch suicide prevention helpline) on 0800-0113.

With us, the question of how you feel is part of every check-up in the medical weight loss with injections programme. The doctor can adjust the dosage, build in a pause or look at whether stopping is sensible together with you; how that works is explained in our article on coming off Ozempic. Bijwerkingencentrum Lareb (the Netherlands Pharmacovigilance Centre) stresses that these medications should be used properly in consultation with a doctor; that applies to mood complaints just as much as to physical side effects. You can also report side effects you notice to Lareb yourself.

What you can do yourself for your energy and mood during treatment

Most of what protects your mood during treatment has to do with eating, moving and sleeping. Semaglutide takes away your appetite, not your body's need for nutrients.

• Eat enough protein, spread over three meals. Too little protein means loss of muscle mass and less energy. You will find practical guidance in our article on an Ozempic diet plan.
• Drink enough. Nausea and eating less quickly lead to too little fluid, and dehydration feels like tiredness and headaches.
• Move every day, with strength training twice a week. Exercise is one of the best-supported ways to improve mood; read more about Ozempic and exercise.
• Protect your sleep. Eating less and a lower weight change your sleep pattern; a fixed routine helps.
• Find new sources of pleasure if food played that role: contact with others, being outdoors, making something.
• Talk about it. With your partner, with friends, with your doctor. A changed relationship with food affects more people than just you.

Prefer to lose weight with your own doctor who follows you at every step? The doctor assesses whether medical weight loss is right for you and stays available, also when things are not going so well. Medical weight loss with injections →

Frequently asked questions about Ozempic and mood

Can Ozempic cause tiredness?

Yes, tiredness is a common side effect (1 to 10 in 100 users). Tiredness also often arises because you take in fewer calories, less protein and less fluid. It usually eases after the dose-building phase; if it persists, discuss it with your doctor.

What does Ozempic do to your hormones?

Semaglutide mimics the gut hormone GLP-1: it stimulates insulin release when blood sugar rises, slows gastric emptying and acts on the hunger and reward centres in the brain. It affects other hormones mainly indirectly, through the weight loss.

Can Ozempic cause depression?

According to the European Medicines Agency's 2024 review, there is no causal link between semaglutide and depression or suicidal thoughts. Mood complaints reported by users usually have an indirect cause. Always discuss low mood that lasts longer than 2 weeks with your doctor or GP.

What are the worst side effects of Ozempic?

The serious but rare side effects are inflammation of the pancreas, gallstones, worsening of existing diabetic eye damage and a severe allergic reaction. A complete overview is in our article on Ozempic side effects; you can read more about eye complaints and your teeth in Ozempic eye problems and Ozempic teeth.

What should you avoid when using Ozempic?

Never increase the dosage yourself, do not skip meals to lose weight faster, and preferably do not drink alcohol; you can read more about that in Ozempic and alcohol. Do not use the medication during pregnancy or if you are trying to conceive, and not alongside other blood sugar lowering medication without consulting your doctor.

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