What to know about Ozempic and antidepressants

In this article:

• Ozempic and antidepressants
• Effect on weight loss
• What to expect
• GLP-1s and depression
• The bottom line

In this article

• Ozempic and antidepressants
• Effect on weight loss
• What to expect
• GLP-1s and depression
• The bottom line

Ozempic (semaglutide) is a glucagon-like peptide-1 receptor agonist, or GLP-1. It was originally approved by the U.S. Food and Drug Administration (FDA) in 2017 to help people with Type 2 diabetes manage their blood sugar levels. The injectable drug’s popularity soared when it was discovered that weight loss was an added bonus. Eventually, the FDA also approved another form of semaglutide, Wegovy, specifically for weight management. 

According to the latest KFF Health Tracking Poll, about 12% of the adult population has taken a GLP-1, like Ozempic or Wegovy. It’s become important to ask if these medications interact with antidepressants—since the rate of antidepressant use is also on the rise. 

Can you take Ozempic with antidepressants?

“It is generally safe to take both antidepressants and a GLP-1 medication,” says Asha Shajahan, MD, a primary care provider with Corewell Health in Rosewell, Michigan.

Zaid Fadul, MD,  a family practice provider and CEO of Bespoke Concierge MD in Scottsdale, Arizona, agrees that it should be safe to take both meds at the same time. “But this combination does require careful monitoring,” he says.

That may be reassuring, especially to people with diabetes, as depression occurs more often in people with diabetes than in people without diabetes. 

Do antidepressants affect the weight-loss effects of Ozempic?

Antidepressants may affect the weight loss potential of GLP-1 drugs, but it may depend on your dosage.

The authors of a retrospective study found that antidepressants can reduce the weight-loss effect of GLP-1 receptor agonists. However, a more recent study in the journal Obesity found that a 2.4 mg dose of semaglutide still causes meaningful weight loss in people with obesity who are taking antidepressants. 

The highest weekly dose of Ozempic for Type 2 diabetes is 2 mg. Since a higher dose—the dose given with Wegovy—was tested in the study, it’s possible that people on lower-dose Ozempic may experience reduced weight loss.

What to expect when taking both medications

All medications have some potential side effects. If you’re taking Ozempic, you could potentially experience gastrointestinal side effects such as nausea, vomiting, constipation, diarrhea, or abdominal pain. Most side effects lessen with time as your body adjusts to the medication. Less common but more serious are side effects such as pancreatitis, hypoglycemia, changes in vision, and dehydration that can lead to kidney problems. 

Antidepressants also can cause side effects, although they can vary, depending on which specific medication you’re taking. Some antidepressants can even cause weight gain. For example, one study found that Lexapro (escitalopram), Paxil (paroxetine), and Cymbalta (duloxetine) were associated with a higher risk of weight gain than some other antidepressants. Meanwhile, Wellbutrin (bupropion) was associated with a reduced risk of weight gain.

When taking both medications, some side effects could be worse. “While clinical studies have not found significant interactions between these medications, potential side effects from either drug can overlap,” Dr. Fadul says. “For instance, both semaglutide and some antidepressants (particularly SSRIs or SNRIs) can cause gastrointestinal issues such as nausea or diarrhea, which may intensify when taken together.” 

GLP-1s and depression

Experts continue to explore the potential effect that taking a medication like semaglutide could have on your mental health. Research shows that obesity and depression have a bidirectional relationship. That means that obesity may contribute to depression, and depression may contribute to obesity. How GLP-1s—such as Novo Nordisk’s Ozempic and Wegovy or Lilly’s Mounjaro and Zepbound (tirzepatide)— factor into the mix is still under examination. Some research shows they increase depression risk, while other studies show they alleviate depression symptoms. 

The results of a recent study suggested that many people who take GLP-1 drugs are at higher risk of receiving a prescription for an antidepressant. The association wasn’t specific to any one particular antidepressant, although the researchers did note that it seemed stronger for Cymbalta (duloxetine). However, the research is preliminary, and an antidepressant prescription isn’t the equivalent of having a depressive disorder. Antidepressants can be prescribed for other purposes, including anxiety.  

Researchers for another study found that GLP-1s may actually be helpful for reducing symptoms of depression in adults. However, they were comparing exenatide and liraglutide to placebo and other diabetes medications that lower glucose levels. More research is needed, including more research about newer GLP-1s, such as Ozempic.  

“I would reassure the patient that current evidence does not support a strong causal link between GLP-1 receptor agonists like semaglutide and depression or anxiety,” says Dr. Fadul. “While there have been isolated reports of mood changes or depressive symptoms in some individuals, these cases are rare and often involve patients with pre-existing psychiatric conditions.” So far, the existing studies don’t find a significant increase in psychiatric adverse events compared to placebo. However, you should always communicate openly with your healthcare team if you experience any mood changes after starting a new medication, like Ozempic.

If you’re taking an antidepressant, don’t stop taking it unless you’re instructed to by your provider. “Abruptly stopping an antidepressant can cause withdrawal symptoms such as worsening anxiety, depression, and mood swings,” says Dr. Shajahan. 

The bottom line

Ozempic has helped a growing number of people manage their diabetes and shed some excess weight, which also helps with their diabetes management. While researchers are still exploring how taking a medication like semaglutide may affect various mental health conditions, it does seem to be safe to take both Ozempic and an antidepressant at the same time. You may experience some side effects, but that may also vary, depending on which antidepressant you’re taking, which GLP-1 you’re taking, and the dosage amount.