Can Tirzepatide Cause Anxiety or Depression?

Medical Disclaimer

This article is for informational purposes only and does not constitute medical advice. The information provided should not be used for diagnosing or treating a health condition. Always consult your healthcare provider before starting, stopping, or changing any medication or treatment plan. Individual results may vary.

Anxiety and depression are not listed side effects of tirzepatide (Zepbound, Mounjaro) in the current US labels, and a January 2026 FDA review of 91 placebo-controlled trials found no increased risk of anxiety, depression or suicidal thoughts with GLP-1 medicines. That is a finding about groups of people, not a promise about you: any new or worsening mood symptom on a GLP-1 is worth telling your prescriber about, and some causes, such as low blood sugar, can be checked.

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Need to talk to someone?

If you're having thoughts of suicide or self-harm, you can call or text 988 (Suicide & Crisis Lifeline, US) any time, or chat at 988lifeline.org. Outside the US, contact your local emergency number.

For other symptoms, see the GLP-1 side effects hub.

Do GLP-1 labels list anxiety or depression? The numbers

From the current US prescribing information for each drug. Anxiety and depression appear only in two Saxenda tables and one pediatric Wegovy table, all at low rates.

Drug	Anxiety (drug vs placebo)	Depression (drug vs placebo)
Zepbound (tirzepatide)	Not listed in the label's common adverse reactions table	Not listed in the label's common adverse reactions table
Mounjaro (tirzepatide)	Not listed in the label's common adverse reactions table	Not listed in the label's common adverse reactions table
Wegovy (semaglutide), adults	Not listed in the label's common adverse reactions table	Not listed in the label's common adverse reactions table
Wegovy, ages 12 and older (Table 5)	4% vs 2%	Not listed
Ozempic (semaglutide)	Not listed in the label's common adverse reactions table	Not listed in the label's common adverse reactions table
Saxenda (liraglutide), adults (Table 2)	2.0% vs 1.6%	Not listed
Saxenda, ages 12 and older (Table 3)	Not listed	4.0% vs 2.4%
Rybelsus (oral semaglutide)	Not listed in the label's common adverse reactions table	Not listed in the label's common adverse reactions table

For the full side-effect list per drug, see Zepbound side effects and Wegovy side effects.

Is depression a side effect of Zepbound or Wegovy? What regulators found

The answer has changed over time, so the dates matter.

Until early 2026, the labels for the three weight-loss GLP-1s (Wegovy, Zepbound and Saxenda) carried a "Suicidal Behavior and Ideation" warning. The FDA says this was based on events seen with older weight-loss medicines, not on a finding specific to GLP-1s. The FDA notes that labels for GLP-1s approved for type 2 diabetes, such as Ozempic, Mounjaro and Rybelsus, do not include it.
January 11, 2024: the FDA said its preliminary evaluation "has not found evidence that use of these medicines causes suicidal thoughts or actions." It added that "we cannot definitively rule out that a small risk may exist" and kept looking.
April 12, 2024: the European Medicines Agency's safety committee (PRAC) "concluded that the available evidence does not support a causal association" between GLP-1 medicines and "suicidal and self-injurious thoughts and actions." That review covered liraglutide, semaglutide and other GLP-1s, but not tirzepatide.
January 13, 2026: the FDA asked the makers of Saxenda, Wegovy and Zepbound to remove the warning. Its meta-analysis of 91 trials (107,910 patients) "did not show an increased risk for SI/B or for other relevant psychiatric adverse events such as anxiety, depression, irritability, or psychosis."
Today: the current labels list the warning as removed (Wegovy 01/2026, Zepbound and Saxenda 02/2026).

For tirzepatide specifically, a 2026 pooled analysis of 4,056 people in three Zepbound trials, funded by the drug's maker, found that depression symptom scores dropped slightly more on tirzepatide than on placebo, a difference the authors did not consider clinically meaningful. Anxiety symptoms were reported by 1.5% on tirzepatide and 3.5% on placebo. But those trials excluded people with a past suicide attempt or recent major depression, bipolar disorder or other serious psychiatric illness. So the data say little about people who live with those conditions.

Why might mood change on a GLP-1?

No label explains a mood effect, and a direct brain effect on mood has not been shown. These are the reasons that have some support:

Low blood sugar. The Medication Guides for all six drugs list anxiety, irritability and mood changes among the signs of low blood sugar. The risk is higher if you also take insulin or a sulfonylurea (such as glipizide).
Feeling physically unwell. Nausea, vomiting and tiredness are common early on. In a small 2024 interview study of nine people on GLP-1s, one described the early nausea as "unbearable at first." Feeling sick for days can wear on mood. See GLP-1 nausea and fatigue.
Eating changes. In the same study, some people changed what they ate to avoid nausea. Others described less worry and fewer cravings around food. The change in your relationship with food can go either way.
What was already there. People with obesity, especially a BMI of 40 or more, are at higher risk of major depression than people without obesity. A mood change during treatment is not automatically the drug.

The same interview study found a mixed picture: most of the nine described better mood, some felt no different, and one person with a history of depression had a new episode during the study.

When does it start, and how long does it last?

The labels give no timeline for mood changes, because they do not list them as a drug effect. That makes your own record more useful. Note when a low or anxious stretch began, whether it lined up with a dose increase, a hard week of nausea, or a life event, and whether it is getting better or worse.

What helps

Tell your prescriber about any new or worsening mood symptoms. The FDA's advice is the same in 2024 and 2026: tell your health care professional about "new or worsening depression, suicidal thoughts, or any unusual changes in mood or behavior." Do not stop or change your GLP-1 dose on your own; the FDA advises against stopping without first talking to your health care professional.
If you take insulin or a sulfonylurea, check your glucose when you feel suddenly anxious, shaky or irritable, and follow your low-blood-sugar plan.
Keep up any mental health care you already have. If you take an antidepressant or anti-anxiety medicine, keep taking it as prescribed. Zepbound's label notes it "has the potential to impact the absorption" of oral medicines, so make sure each prescriber knows about the other.
Eat regular small meals and drink through the day. Going most of the day on very little food can leave you drained and unwell. Our protein calculator can help you set a target to confirm with your clinician.
Protect your sleep. Poor sleep and low mood feed each other. See GLP-1 insomnia.
Tell someone you trust how you have been feeling, so you are not watching it alone.

When to get help

Thoughts of suicide or self-harm: call or text 988 now, or 911 if you are in danger. Do not wait for an appointment.
New or worsening depression or anxiety, or unusual changes in mood or behavior: contact your prescriber. If it is getting worse, do not wait for a routine visit.
Shakiness, sweating, confusion or a fast heartbeat while on insulin or a sulfonylurea: treat it as possible low blood sugar and contact your care team.
A history of depression, bipolar disorder or a suicide attempt: make sure your prescriber knows before and during treatment. The Zepbound trials excluded people with a past suicide attempt or recent major depression or bipolar disorder, so there is less evidence for you.

What to track and why

In GLP AI you can log anxious, depressed, mood swings and foggy from the side-effect catalog, each with a severity from 1 to 10, next to your doses. Before an appointment, you can export the doctor report PDF and bring it to your prescriber, along with the questions in our doctor visit prep guide. The app is a symptom tracker, not a mental health tool or a crisis service.

GLP-1 Mood, Anxiety and Depression FAQ

Can tirzepatide cause depression?

Depression is not listed in the Zepbound or Mounjaro common adverse reactions tables. A 2026 pooled analysis of three Zepbound trials found no increased risk of depression symptoms versus placebo, but those trials excluded people with recent major depression or serious psychiatric illness. Tell your prescriber about any new or worsening low mood.

Does Zepbound still have a suicide warning?

No. On January 13, 2026 the FDA asked for the Suicidal Behavior and Ideation warning to be removed from Zepbound, Wegovy and Saxenda after a review found no increased risk. The current Zepbound label lists it as removed (02/2026). If you have thoughts of suicide or self-harm, call or text 988 in the US.

Can Wegovy cause depression?

Depression is not listed in the adult Wegovy common adverse reactions tables. The FDA's 2026 meta-analysis of 91 placebo-controlled trials did not show an increased risk of depression or anxiety with GLP-1 medicines. A mood change on Wegovy still deserves a conversation with your prescriber.

Is anxiety a side effect of Mounjaro or Ozempic?

Anxiety is not listed in their common adverse reactions tables. Both Medication Guides list anxiety, irritability or mood changes as possible signs of low blood sugar, which is more likely if you also take insulin or a sulfonylurea. Check your glucose if you can and contact your care team.

Should I stop my GLP-1 if I feel depressed or anxious?

Do not stop or change your dose on your own. The FDA advises patients to keep taking their medication as prescribed and to tell their health care professional about new or worsening depression, suicidal thoughts or unusual changes in mood or behavior. Your prescriber decides any change.

Sources verified 2026-10-26

988 Suicide & Crisis Lifeline: call, text or chat 988, free and confidential, 24/7/365.
Zepbound prescribing information (USPI, revised 08/2026): Recent Major Changes, "Suicidal Behavior and Ideation (Removed) 02/2026"; Table 1 (anxiety and depression not listed); section 7.2 oral medications. Zepbound Medication Guide (revised 08/2026): signs of low blood sugar.
Mounjaro prescribing information (USPI, revised 08/2026): Table 1 (not listed). Mounjaro Medication Guide: signs of low blood sugar.
Wegovy prescribing information (revised 06/2026): Recent Major Changes, "Suicidal Behavior and Ideation (5.10) (Removed) 01/2026"; Table 5 pediatric anxiety (4% vs 2%); Medication Guide signs of low blood sugar.
Ozempic prescribing information (revised 05/2026): not listed; Medication Guide signs of low blood sugar.
Saxenda prescribing information (revised 02/2026): "Suicidal Behavior and Ideation (5.9) (Removed) 02/2026"; Table 2 anxiety (2.0% vs 1.6%); Table 3 pediatric depression (4.0% vs 2.4%).
Rybelsus prescribing information (revised 01/2026): not listed.
FDA Drug Safety Communication, January 13, 2026: FDA Requests Removal of Suicidal Behavior and Ideation Warning from GLP-1 RA Medications.
FDA Drug Safety Communication, January 11, 2024: Update on FDA's ongoing evaluation of reports of suicidal thoughts or actions.
European Medicines Agency, April 12, 2024: Meeting highlights from PRAC, 8-11 April 2024.
Wadden TA, et al. Psychiatric safety of tirzepatide in people with obesity and no known major psychopathology: a post hoc analysis of SURMOUNT. Obesity (Silver Spring). 2026;34(3):565-578. Post hoc analysis of SURMOUNT-1, -2 and -3; funded by Eli Lilly.
Pierret ACS, et al. A qualitative study of the mental health outcomes in people being treated for obesity and type 2 diabetes with GLP-1 receptor agonists. Acta Diabetol. 2025;62(5):731-742 (published online November 2024).

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Editorial

Educational content from the GLP AI team about living on a GLP-1. Clinical review is credited by name on pages a reviewer has checked. Not medical advice.