Fresh, alarming warnings about Ozempic-like drugs

Popular drugs like Zepbound and Wegovy that promise a slimmer profile can trigger much more than weight loss.

These medications can spur a slew of potential side effects, like nausea, vomiting, constipation, diarrhea, headaches and changes to the skin.

One possible consequence is especially dire for the 10 million Americans using GLP-1s.

Australia’s Therapeutic Goods Administration (TGA), which regulates medicines and medical devices, has issued new safety warnings regarding mental health and birth control for those taking GLP-1 medications.

After a World Health Organization study raised alarm bells that several weight loss drug users reported suicidal behavior and thoughts of suicide, the TGA further investigated the claims.

As recently as September, the TGA database featured 72 reports of suicidal ideation, six reports of suicide related to depression and four attempted suicides from those on GLP-1s.

While there wasn’t enough evidence to directly link the drugs to these events, the TGA advises that doctors should “monitor patients for the emergence or worsening of depression, suicidal thoughts or behaviors and/or any unusual changes in mood or behavior.”

The agency also issued a separate warning that Mounjaro could potentially reduce the effectiveness of oral contraception.

This follows the UK’s Medicines and Healthcare Products Regulatory Agency warning from earlier this year that tirzepatide, sold as Mounjaro and Zepbound, may reduce the effectiveness of oral contraceptives.

While the WHO study saw reports of suicidal thoughts were slightly higher for semaglutide in particular, the warning applies for all GLP-1s, including Saxenda, Trulicity and Mounjaro. Semaglutide is sold as Ozempic or Wegovy.

Previous research had found “reassuring” results that weight loss and diabetes drugs don’t directly increase the risks of depression or suicide.

The US Food and Drug Administration investigated reports of suicidal thoughts or behavior by GLP-1 users in 2024, finding no evidence that these medicines cause either.

But some experts suggest that a particular group of users may be more susceptible to these risks than others.

“At the moment, [patients who may be more vulnerable to a worsening of their mental health] seems to be people who might already have a past or current history of depression or anxiety or on a antidepressant type medication,” Terri-Lynne South, the chair of the Royal Australian College of General Practitioners’ specific interest group for obesity management, told The Guardian.

She added that bariatric surgery and significant weight loss can be a “real triggering event from a mental health point of view.”

Regarding birth control, there’s no evidence that GLP-1s affect non-oral birth control like IUDs, implants, patches or rings, according to the UK’s Faculty of Reproductive Healthcare.

Since these drugs slow digestion, everything ingested is affected — including oral contraceptive pills.

“[The drug] delays the food and everything else that you eat actually coming through the digestive system,” South explained, “therefore having an impact on the absorption of the oral contraceptive pill and possibly the effectiveness of the oral contraceptive pill.”

If you’re on tirzepatide and trying not to get pregnant, experts recommend using a backup method like condoms for four weeks after starting the medication and with each dose increase.

And those who are already pregnant shouldn’t use weight loss drugs, as there’s not enough data to confirm whether they’re safe during pregnancy.

Some human studies suggest there’s no harm in first-trimester use, but testing in animals has shown the drugs could increase the risk of miscarriage and birth defects.

The two new warnings issued by the TGA were part of its normal post-market investigation and all medications were properly updated.

If you are struggling with suicidal thoughts or are experiencing a mental health crisis and live in New York City, you can call 1-888-NYC-WELL for free and confidential crisis counseling. If you live outside the five boroughs, you can dial the 24/7 National Suicide Prevention hotline at 988 or go to SuicidePreventionLifeline.org.