Ozempic Doesn’t Warn About Mental Health Side Effects, but Wegovy Does

• Ozempic’s label does not list anxiety, depression, or suicidal thoughts, while Wegovy’s label does.
• Both Ozempic and Wegovy share the same active compound, semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.
• If you notice changes in your mental well-being while using a GLP-1 such as Ozempic or Wegovy, contact your healthcare provider right away.

Many people are familiar with Ozempic and Wegovy, but they may not realize the distinctions in how each medication’s labeling addresses potential mental health effects.

Wegovy’s prescribing information includes mental health adverse events that Ozempic’s does not. Yet both medications contain semaglutide, which, per Wegovy’s warning language, could be associated with an increased risk of:

• anxiety
• depression
• suicidal thoughts and attempts

Dr. Sethu Reddy, president of the American Association of Clinical Endocrinology, told HealthEH that there’s a reasonable explanation for this difference. “It’s not that the FDA or [the manufacturer] are being deceptive or withholding information,” he said.

Reddy clarified that during clinical trials for FDA approval, companies are required to collect and report any adverse events that occur more often in the treatment group than in the placebo group.

Still, mental health consequences should not be downplayed, emphasized Dr. Raafat Girgis, a psychiatrist and clinical director at Moment of Clarity. “Patients have the right to know both the risks and benefits of any medication or product,” Girgis told HealthEH.

Can semaglutide cause mental health problems?

Semaglutide is the active ingredient in both Ozempic and Wegovy and acts as a GLP-1 receptor agonist.

This drug imitates the GLP-1 hormone released in the gut after eating. GLP-1 stimulates insulin secretion, which lowers blood glucose; this is why Ozempic is used to treat diabetes.

At higher doses, GLP-1 agonists also affect brain regions that suppress appetite and promote a feeling of fullness. That mechanism explains how the semaglutide in Wegovy supports weight loss.

The greater dose of semaglutide in Wegovy compared with Ozempic might explain why more mental health adverse events were observed during Wegovy’s clinical trials, Reddy suggested.

“When medications act to diminish appetite, other neural changes can follow, ranging from depression to anxiety,” he said. “You may see fewer of these effects with GLP-1s like semaglutide, but any medication that influences the brain warrants attention to central nervous system side effects.”

Reddy also pointed out that the psychological context differs: people taking Wegovy for weight loss may have different mental health backgrounds than those taking Ozempic for diabetes, which could influence outcomes.

“Mental health plays a major role in eating behaviors — stress, whether negative or positive, often triggers eating; anxiety is a major factor; social views on weight, and emotional coping strategies can all contribute,” Reddy said.

Girgis noted that common side effects of both Ozempic and Wegovy could precipitate mental health symptoms. These include:

• nausea
• vomiting
• constipation
• diarrhea

“The most troublesome side effects are the gastrointestinal ones,” Girgis said.

“When the digestive system isn’t functioning normally, the body attempts to compensate, which can throw off usual physiological balance. That disruption, combined with worry and anxiety, can exacerbate how the body responds to the treatment.”

He also noted that dehydration stemming from GI effects can negatively affect mental health.

What to do if semaglutide impacts your mental health

If you experience changes in mood or mental health while on a GLP-1 such as Ozempic or Wegovy, reach out to your clinician right away.

“If your provider is unavailable, go to the emergency department or an urgent care center,” Girgis advised.

There are alternative medications and approaches for both diabetes and weight management. Typically, clinicians will first try lowering the dose to see if adverse mental effects subside.

“Every medicine has a therapeutic window — too much of a drug can cause side effects while an appropriate dose achieves benefit without harm,” Reddy explained. “Doctors try to find the dose that’s effective but tolerable.”

After adjustments, they may pause the medication for several weeks to observe whether mental health improves and then restart it.

“If mood symptoms recur upon restarting, that helps clarify the link and we’ll usually attempt a reduced dose or a different therapy,” Reddy said.

How do hormones influence mental state?

The mental effects of hormones depend on the specific hormone, its intended use, and the individual’s sex.

For example, Reddy said that insulin, when administered in appropriate doses, typically doesn’t alter mental health.

Other hormones, such as testosterone and estrogen, have more variable effects.

Girgis noted that testosterone can sometimes provoke issues like rage, agitation, and increased aggression.

Reddy added that for men with low testosterone, replacement therapy may actually improve mood, energy, and exercise capacity.

Similarly, if a woman experiences mood changes during menopause, oral estrogen can in some cases relieve depression and anxiety, Reddy said.

Girgis emphasized that “depression, mood swings, anxiety, and sadness can occur in anyone when injectable hormones are introduced into the body.”

How mental health side effects get added to drug labels

After a drug is approved and widely used, clinicians must continue to report observed adverse events to the FDA Adverse Event Reporting System (FAERS).

“Some side effects only emerge when a medication is used in a far larger population. Something that affects one or two people in a million won’t appear in the smaller clinical trials used for FDA approval,” Reddy said.

“That doesn’t mean manufacturers are concealing risks; it reflects how data accumulates over time.”

As more adverse events are reported, researchers may investigate and, if warranted, those effects can be added to the product label.

Takeaway

The reason Ozempic’s label omits anxiety, depression, and suicide while Wegovy’s includes them may relate to Wegovy’s higher semaglutide dose.

This difference is prompting additional research into the relationship between semaglutide dose and mental health effects.

If you suspect you’re experiencing mental health changes while using Ozempic, Wegovy, or another GLP-1, contact your healthcare provider without delay.