{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T00:25:51Z","timestamp":1794097551636,"version":"4.8.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Drugs Ther"],"published-print":{"date-parts":[[2025,12]]},"DOI":"10.1007\/s10557-024-07613-w","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T14:06:41Z","timestamp":1726495601000},"page":"1331-1341","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Risk of Suicide, Hair Loss, and Aspiration with GLP1-Receptor Agonists and Other Diabetic Agents: A Real-World Pharmacovigilance Study"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8016-9679","authenticated-orcid":false,"given":"Michael","family":"Nakhla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambica","family":"Nair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prachi","family":"Balani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi","family":"Ujjawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pramukh","family":"Arun Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahati","family":"Dasari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"Yukselen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kannu","family":"Bansal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarju","family":"Ganatra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourbha S.","family":"Dani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"issue":"1","key":"7613_CR1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.metabol.2013.09.010","volume":"63","author":"YS Lee","year":"2014","unstructured":"Lee YS, Jun HS. Anti-diabetic actions of glucagon-like peptide-1 on pancreatic beta-cells. Metabolism. 2014;63(1):9\u201319. https:\/\/doi.org\/10.1016\/j.metabol.2013.09.010.","journal-title":"Metabolism"},{"issue":"12","key":"7613_CR2","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1056\/NEJMoa2306963","volume":"389","author":"MN Kosiborod","year":"2023","unstructured":"Kosiborod MN, Abildstrom SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069\u201384. https:\/\/doi.org\/10.1056\/NEJMoa2306963.","journal-title":"N Engl J Med"},{"issue":"24","key":"7613_CR3","doi-asserted-by":"publisher","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","volume":"389","author":"AM Lincoff","year":"2023","unstructured":"Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221\u201332. https:\/\/doi.org\/10.1056\/NEJMoa2307563.","journal-title":"N Engl J Med"},{"issue":"5","key":"7613_CR4","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1001\/jamainternmed.2022.0338","volume":"182","author":"L He","year":"2022","unstructured":"He L, Wang J, Ping F, et al. Association of glucagon-like peptide-1 receptor agonist use with risk of gallbladder and biliary diseases: a systematic review and meta-analysis of randomized clinical trials. JAMA Intern Med. 2022;182(5):513. https:\/\/doi.org\/10.1001\/jamainternmed.2022.0338.","journal-title":"JAMA Intern Med"},{"issue":"3","key":"7613_CR5","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1111\/dom.15382","volume":"26","author":"GA Silverii","year":"2024","unstructured":"Silverii GA, Monami M, Gallo M, et al. Glucagon-like peptide-1 receptor agonists and risk of thyroid cancer: a systematic review and meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2024;26(3):891\u2013900. https:\/\/doi.org\/10.1111\/dom.15382.","journal-title":"Diabetes Obes Metab"},{"key":"7613_CR6","unstructured":"Dillinger K. FDA looking into reports of hair loss, suicidal thoughts in people using popular drugs for diabetes and weight loss. In: CNN. 2024. https:\/\/www.cnn.com\/2024\/01\/03\/health\/glp1-agonist-side-effects-fda\/index.html. Accessed 7 Feb 2024."},{"key":"7613_CR7","unstructured":"Reuters. E.U. investigates Ozempic, Saxenda after suicidal thoughts reported. In: NBC News. 2023. https:\/\/www.nbcnews.com\/news\/world\/eu-investigates-ozempic-saxenda-suicidal-thoughts-reported-rcna93552. Accessed 7 Feb 2024."},{"key":"7613_CR8","unstructured":"Pelc C. Can GLP-1 drugs Ozempic and Wegovy cause suicidal ideation, hair loss? In: MedicalNewsToday. 2024. https:\/\/www.medicalnewstoday.com\/articles\/ozempic-wegovy-side-effects-suicidal-ideation-hair-loss. Accessed 7 Feb 2024."},{"key":"7613_CR9","unstructured":"Manalac T. FDA probes GLP-1 receptor agonists on reports of suicidal thoughts, hair loss. In: BioSpace. 2024. https:\/\/www.biospace.com\/article\/novo-lilly-weight-loss-drugs-under-fda-scrutiny-for-suicidal-thoughts-hair-loss\/. Accessed 8 Feb 2024."},{"key":"7613_CR10","unstructured":"EMA statement on ongoing review of GLP-1 receptor agonists. In: European Medicines Agency. 2023. https:\/\/www.ema.europa.eu\/en\/news\/ema-statement-ongoing-review-glp-1-receptor-agonists. Accessed 8 Feb 2024."},{"key":"7613_CR11","unstructured":"Semaglutide Responsible Use | Official Website. In: novoMEDLINK. https:\/\/www.novomedlink.com\/semaglutide.html. Accessed 8 Feb 2024."},{"key":"7613_CR12","doi-asserted-by":"publisher","first-page":"964399","DOI":"10.3389\/fphar.2022.964399","volume":"13","author":"K Pozsgai","year":"2022","unstructured":"Pozsgai K, Sz\u0171cs G, K\u0151nig-P\u00e9ter A, et al. Analysis of pharmacovigilance databases for spontaneous reports of adverse drug reactions related to substandard and falsified medical products: a descriptive study. Front Pharmacol. 2022;13:964399. https:\/\/doi.org\/10.3389\/fphar.2022.964399.","journal-title":"Front Pharmacol"},{"key":"7613_CR13","doi-asserted-by":"publisher","unstructured":"B\u00f6hm R, Von Hehn L, Herdegen T et al. OpenVigil FDA \u2013 inspection of U.S. American adverse drug events pharmacovigilance data and novel clinical applications. PLOS ONE. 2016;11(6):e0157753. https:\/\/doi.org\/10.1371\/journal.pone.0157753.","DOI":"10.1371\/journal.pone.0157753"},{"issue":"6","key":"7613_CR14","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1002\/pds.677","volume":"10","author":"SJW Evans","year":"2001","unstructured":"Evans SJW, Waller PC, Davis S. Use of proportional reporting ratios (PRRs) for signal generation from spontaneous adverse drug reaction reports. Pharmacoepidemiol Drug. 2001;10(6):483\u20136. https:\/\/doi.org\/10.1002\/pds.677.","journal-title":"Pharmacoepidemiol Drug"},{"key":"7613_CR15","unstructured":"Ramya. 46: The Information Component | Pharmacovigilance. In: All About Pharmacovigilance. 2020. https:\/\/allaboutpharmacovigilance.org\/46-the-information-component\/. Accessed 8 Feb 2024."},{"key":"7613_CR16","unstructured":"Obesity Medicines & Food Industry Impact. In: Morgan Stanley. 2023. https:\/\/www.morganstanley.com\/ideas\/obesity-drugs-food-industry. Accessed 8 Feb 2024."},{"issue":"1","key":"7613_CR17","doi-asserted-by":"publisher","first-page":"e99","DOI":"10.1192\/j.eurpsy.2023.2474","volume":"66","author":"C Chen","year":"2023","unstructured":"Chen C, Zhou R, Fu F, Xiao J. Postmarket safety profile of suicide\/self-injury for GLP-1 receptor agonist: a real-world pharmacovigilance analysis. Eur Psychiatr. 2023;66(1):e99. https:\/\/doi.org\/10.1192\/j.eurpsy.2023.2474.","journal-title":"Eur Psychiatr"},{"issue":"1","key":"7613_CR18","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1038\/s41591-023-02672-2","volume":"30","author":"W Wang","year":"2024","unstructured":"Wang W, Volkow ND, Berger NA, et al. Association of semaglutide with risk of suicidal ideation in a real-world cohort. Nat Med. 2024;30(1):168\u201376. https:\/\/doi.org\/10.1038\/s41591-023-02672-2.","journal-title":"Nat Med"},{"key":"7613_CR19","doi-asserted-by":"publisher","unstructured":"O'Neil PM, Aroda VR, Astrup A et al. Neuropsychiatric safety with liraglutide 3.0 mg for weight management: results from randomized controlled phase 2 and 3a trials. Diabetes Obes Metab. 2017;19(11):1529\u201336. https:\/\/doi.org\/10.1111\/dom.12963.","DOI":"10.1111\/dom.12963"},{"issue":"7","key":"7613_CR20","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1007\/s00592-023-02063-6","volume":"60","author":"JV Mui","year":"2023","unstructured":"Mui JV, Li L, Chou OHI, et al. Comparing sodium-glucose cotransporter 2 inhibitors and dipeptidyl peptidase-4 inhibitors on new-onset depression: a propensity score-matched study in Hong Kong. Acta Diabetol. 2023;60(7):917\u201327. https:\/\/doi.org\/10.1007\/s00592-023-02063-6.","journal-title":"Acta Diabetol"},{"issue":"2","key":"7613_CR21","doi-asserted-by":"publisher","first-page":"147","DOI":"10.3390\/ph17020147","volume":"17","author":"R Ruggiero","year":"2024","unstructured":"Ruggiero R, Mascolo A, Spezzaferri A, et al. Glucagon-like peptide-1 receptor agonists and suicidal ideation: analysis of real-word data collected in the European pharmacovigilance database. Pharmaceuticals. 2024;17(2):147. https:\/\/doi.org\/10.3390\/ph17020147.","journal-title":"Pharmaceuticals"},{"issue":"1","key":"7613_CR22","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1080\/14740338.2023.2295397","volume":"23","author":"RS McIntyre","year":"2024","unstructured":"McIntyre RS, Mansur RB, Rosenblat JD, Kwan ATH. The association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and suicidality: reports to the Food and Drug Administration Adverse Event Reporting System (FAERS). Expert Opin Drug Saf. 2024;23(1):47\u201355. https:\/\/doi.org\/10.1080\/14740338.2023.2295397.","journal-title":"Expert Opin Drug Saf"},{"issue":"10","key":"7613_CR23","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.4088\/JCP.16f11196","volume":"77","author":"C Andrade","year":"2016","unstructured":"Andrade C. Metformin as a possible intervention for cardiometabolic risks in pediatric subjects exposed to antipsychotic drugs: (clinical and pricatical psychopharmacology). J Clin Psychiatry. 2016;77(10):1362\u20134. https:\/\/doi.org\/10.4088\/JCP.16f11196.","journal-title":"J Clin Psychiatry"},{"key":"7613_CR24","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.euroneuro.2024.02.003","volume":"82","author":"A Guirguis","year":"2024","unstructured":"Guirguis A, Chiappini S, Papanti PG, et al. Exploring the association between suicidal thoughts, self-injury, and GLP-1 receptor agonists in weight loss treatments: insights from pharmacovigilance measures and unmasking analysis. Eur Neuropsychopharmacol. 2024;82:82\u201391. https:\/\/doi.org\/10.1016\/j.euroneuro.2024.02.003.","journal-title":"Eur Neuropsychopharmacol"},{"issue":"1","key":"7613_CR25","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1038\/s41380-018-0017-5","volume":"24","author":"Y Milaneschi","year":"2019","unstructured":"Milaneschi Y, Simmons WK, Van Rossum EFC, Penninx BW. Depression and obesity: evidence of shared biological mechanisms. Mol Psychiatry. 2019;24(1):18\u201333. https:\/\/doi.org\/10.1038\/s41380-018-0017-5.","journal-title":"Mol Psychiatry"},{"key":"7613_CR26","unstructured":"Hansel B. GLP-1 agonists and suicide risk: is action needed? In: Medscape. 2023. https:\/\/www.medscape.com\/viewarticle\/996484. Accessed 9 Feb 2024."},{"issue":"4","key":"7613_CR27","doi-asserted-by":"publisher","first-page":"e760","DOI":"10.1097\/SLA.0000000000005825","volume":"278","author":"A Hung","year":"2023","unstructured":"Hung A, Maciejewski ML, Berkowitz TSZ, et al. Bariatric surgery and suicide risk in patients with obesity. Ann Surg. 2023;278(4):e760\u20135. https:\/\/doi.org\/10.1097\/SLA.0000000000005825.","journal-title":"Ann Surg"},{"issue":"1","key":"7613_CR28","doi-asserted-by":"publisher","first-page":"145","DOI":"10.3390\/jcm12010145","volume":"12","author":"JJ Gorgojo-Mart\u00ednez","year":"2022","unstructured":"Gorgojo-Mart\u00ednez JJ, Mezquita-Raya P, Carretero-G\u00f3mez J, et al. Clinical recommendations to manage gastrointestinal adverse events in patients treated with Glp-1 receptor agonists: a multidisciplinary expert consensus. JCM. 2022;12(1):145. https:\/\/doi.org\/10.3390\/jcm12010145.","journal-title":"JCM"},{"key":"7613_CR29","doi-asserted-by":"publisher","unstructured":"Guo EL, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatol Pract Concept. 2017; 1\u201310. https:\/\/doi.org\/10.5826\/dpc.0701a01","DOI":"10.5826\/dpc.0701a01"},{"issue":"2","key":"7613_CR30","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1001\/archderm.1977.01640020106020","volume":"113","author":"GL Blackburn","year":"1977","unstructured":"Blackburn GL, Bistrian BR, Hoag C. Hair loss with rapid weight loss. Arch Dermatol. 1977;113(2):234.","journal-title":"Arch Dermatol"},{"key":"7613_CR31","unstructured":"Kobren SD. Misuse of ozempic for rapid weight loss can cause significant and perhaps permanent hair loss. In: Dermatology Times. 2023. https:\/\/www.dermatologytimes.com\/view\/misuse-of-ozempic-for-rapid-weight-loss-can-cause-significant-and-perhaps-permanent-hair-loss. Accessed 8 Feb 2024"},{"key":"7613_CR32","unstructured":"Telogen effluvium: symptoms, causes, treatment & regrowth. In: Cleveland Clinic. https:\/\/my.clevelandclinic.org\/health\/diseases\/24486-telogen-effluvium. Accessed 9 Feb 2024."},{"key":"7613_CR33","unstructured":"Wegovy\u00ae STEP 4 Clinical Trial Results | Wegovy\u00ae (semaglutide) injection 2.4 mg. In: novoMEDLINK. https:\/\/www.novomedlink.com\/obesity\/products\/treatments\/wegovy\/efficacy-safety\/clinical-trial-4-results.html. Accessed 8 Feb 2024."},{"issue":"8","key":"7613_CR34","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1080\/00325481.2015.1090295","volume":"127","author":"CF Shaefer","year":"2015","unstructured":"Shaefer CF, Kushner P, Aguilar R. User\u2019s guide to mechanism of action and clinical use of GLP-1 receptor agonists. Postgrad Med. 2015;127(8):818\u201326. https:\/\/doi.org\/10.1080\/00325481.2015.1090295.","journal-title":"Postgrad Med"},{"key":"7613_CR35","unstructured":"Daniella Nunez KL. Glucagon-like peptide 1 receptor agonists and aspiration risk. In: OpenAnesthesia. 2023. https:\/\/www.openanesthesia.org\/keywords\/glucagon-like-peptide-1-receptor-agonists-and-aspiration-risk\/. Accessed 8 Feb 2024."},{"key":"7613_CR36","doi-asserted-by":"publisher","unstructured":"Hashash JG, Thompson CC, Wang AY. AGA rapid clinical practice update on the management of patients taking GLP-1 receptor agonists prior to endoscopy: communication. Clin Gastroenterol Hepatol. 2023; S1542356523008698. https:\/\/doi.org\/10.1016\/j.cgh.2023.11.002.","DOI":"10.1016\/j.cgh.2023.11.002"},{"key":"7613_CR37","unstructured":"Joshi GP. American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists. In: American Society of Anesthesiologists. 2023. https:\/\/www.asahq.org\/about-asa\/newsroom\/news-releases\/2023\/06\/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative. Accessed 8 Feb 2024."},{"key":"7613_CR38","doi-asserted-by":"publisher","unstructured":"Van Zuylen ML, Siegelaar SE, Plummer MP et al. Perioperative management of long-acting glucagon-like peptide-1 (GLP-1) receptor agonists: concerns for delayed gastric emptying and pulmonary aspiration. Br J Anaesth. 2024; S0007091224000023. https:\/\/doi.org\/10.1016\/j.bja.2024.01.001.","DOI":"10.1016\/j.bja.2024.01.001"},{"key":"7613_CR39","doi-asserted-by":"publisher","unstructured":"Brunton S. GLP-1 receptor agonists vs. DPP-4 inhibitors for type 2 diabetes: is one approach more successful or preferable than the other? Int J Clin Pract. 2014; 68(5):557\u201367. https:\/\/doi.org\/10.1111\/ijcp.12361.","DOI":"10.1111\/ijcp.12361"},{"issue":"4","key":"7613_CR40","doi-asserted-by":"publisher","first-page":"177","DOI":"10.4103\/picr.picr_169_22","volume":"13","author":"M Desai","year":"2022","unstructured":"Desai M. Pharmacovigilance and spontaneous adverse drug reaction reporting: challenges and opportunities. Perspect Clin Res. 2022;13(4):177. https:\/\/doi.org\/10.4103\/picr.picr_169_22.","journal-title":"Perspect Clin Res"}],"container-title":["Cardiovascular Drugs and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10557-024-07613-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10557-024-07613-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10557-024-07613-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T07:01:15Z","timestamp":1766127675000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10557-024-07613-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["7613"],"URL":"https:\/\/doi.org\/10.1007\/s10557-024-07613-w","relation":{},"ISSN":["0920-3206","1573-7241"],"issn-type":[{"value":"0920-3206","type":"print"},{"value":"1573-7241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,12]]},"assertion":[{"value":"28 July 2024","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2024","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This is an observational study conducted from publicly available databases using deidentified information, therefore, no IRB approval was required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}