GLP-1 Medications and Mental Health: Cravings, Mood and What to Tell Your Psychiatric Provider

Medications like semaglutide and tirzepatide have become some of the most talked-about prescriptions in years. If you take one, or are thinking about it, you may have heard they can quiet cravings for alcohol, or wondered whether they affect mood. Here's what's known about GLP-1 and mental health so far, and what's still an open question.

Key takeaways

• GLP-1 medications are FDA-approved for type 2 diabetes, weight management and certain related conditions.
• Researchers are studying whether they reduce cravings for alcohol and other substances, but this is not an FDA-approved use.
• Regulators have looked into reports of mood changes and suicidal thoughts. Tell your prescriber about any change in your mood.
• People with a past or current eating disorder need extra caution.
• Tell your psychiatric provider if you take one, and keep all your prescribers in the loop.

If you're struggling right now: If you have thoughts of harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline. Call 911 in an emergency, or text HOME to 741741. You can find more options on our crisis resources page.

What GLP-1 medications are

GLP-1 is a hormone your gut releases after you eat. Medications that act like it help the body release insulin, slow how quickly the stomach empties and send fullness signals to the brain.

Common examples include semaglutide (sold as Ozempic, Wegovy and Rybelsus) and tirzepatide (sold as Mounjaro and Zepbound). Tirzepatide also acts on a second gut hormone called GIP. Older medications in this family include liraglutide and dulaglutide.

GLP-1 receptors are also found in the brain, including areas tied to reward and motivation. That's a big part of why researchers became curious about effects beyond blood sugar and weight.

GLP-1 and cravings: what research is exploring

Many people on these medications say the constant "food noise" in their head gets quieter. Some also notice less interest in alcohol. That has sparked research into whether GLP-1 medications could help reduce drinking, and to a lesser extent nicotine, opioid and other substance use.

So far, the research includes animal studies, reviews of health records and a small number of clinical trials in people. The early findings have been promising enough to support larger studies, but the question isn't settled.

Important limits to keep in mind

• GLP-1 medications are not FDA-approved to treat alcohol use disorder or any other substance use disorder.
• Findings from groups of people can't predict how any one person will respond.
• Proven, FDA-approved medications for alcohol and opioid use disorders already exist. Our post on anxiety and substance use describes them.
• The FDA has warned about unapproved and counterfeit versions of these medications, which may not contain what the label says.

If you hope a GLP-1 medication might help with drinking, bring it up with your provider. Outpatient addiction psychiatry can cover the options with the strongest evidence and whether a GLP-1 makes sense for other health reasons.

GLP-1 and mental health: questions about mood

Some people have reported depression, mood changes or suicidal thoughts while taking these medications. Those reports led regulators in the United States and Europe to look into whether there's a link. Their reviews have not established that GLP-1 medications cause these problems, but reports alone can't settle the question, and research is ongoing.

The prescribing information for some versions used for weight management advises watching for depression and suicidal thoughts. That's a reason to pay attention, not a reason to panic.

Many things can affect mood while you're on one of these medications:

• Eating much less, which can affect energy, sleep and focus
• Nausea, vomiting or other stomach side effects
• Losing food as a source of comfort or a way to cope with stress
• Body image changes, in either direction
• Better physical health, which lifts mood for some people

Before you start, tell your prescriber about any history of depression, anxiety or suicidal thoughts. Once you're on the medication, notice how you feel. Report changes in mood, sleep, interest or energy, and seek help right away if you have thoughts of harming yourself.

Eating-disorder cautions

Because GLP-1 medications reduce appetite, they call for extra care if you've ever had an eating disorder, such as anorexia, bulimia or binge eating disorder. Less hunger can make restrictive eating easier to slip into and harder for others to notice. Eating too little can also lead to nutrition gaps, which our post on nutritional deficiencies and mental health explores.

Researchers are studying GLP-1 medications for binge eating, but that isn't an approved use. Signs that things may be heading in a harmful direction include:

• Skipping meals on purpose, beyond what the medication causes
• Intense fear of regaining any weight
• Thinking about food, weight or your body most of the day
• Getting the medication without a prescription or taking more than prescribed

Our practice doesn't run eating-disorder programs, but our team can evaluate your symptoms and help you connect with specialized care if you need it.

Why your psychiatric provider needs to know

Even when no direct interaction is expected, a GLP-1 medication can affect your psychiatric care in a few ways:

• Medication absorption. Slower stomach emptying may change how some medications taken by mouth are absorbed. Tirzepatide can make birth control pills less effective for a time, so ask about backup contraception.
• Dehydration. Vomiting or diarrhea can cause dehydration, which can raise lithium levels. If you take lithium, your prescriber needs to know right away.
• Weight and appetite. Some psychiatric medications cause weight gain, and researchers are studying GLP-1 medications for this. ADHD stimulants also lower appetite, so taking both can add up.
• Low blood sugar. With certain diabetes medications, low blood sugar can feel like anxiety, with shakiness, sweating and irritability.

With your permission, your psychiatric provider and the doctor who prescribes your GLP-1 can share information and plan together. Don't stop or change a psychiatric medication because you started a GLP-1, or the other way around, without talking with your prescribers first.

Frequently asked questions

Can a GLP-1 medication treat my drinking?

Not as an approved use. Research is exploring whether these medications reduce alcohol cravings, but results are early. FDA-approved medications for alcohol use disorder exist now, and the National Institute on Alcohol Abuse and Alcoholism has helpful information about treatment.

Do GLP-1 medications cause depression?

That hasn't been established. Some people have reported mood changes, and regulators have reviewed those reports while research continues. Tell your prescriber if your mood shifts after starting or changing a dose.

Can I take a GLP-1 medication with my antidepressant?

Many people take both. Still, every prescriber you see should have your full medication list, including doses. Talk with your prescriber before starting, stopping or changing any medication.

Is it safe to buy these medications online without a prescription?

It's not recommended. The FDA has warned about counterfeit and unapproved versions that may contain the wrong ingredients or amounts. Get these medications only through a licensed prescriber and a licensed pharmacy.

Get coordinated care for your whole health

Your physical and mental health affect each other, and your care should reflect that. At Musec Medical, our psychiatrist and psychiatric physician assistants work alongside your other doctors, in person in Chicago and by telehealth anywhere in Illinois. Request an appointment to talk about your medications and goals.