---
type: claim
domain: health
description: Concurrent use of GLP-1 receptor agonists with antidepressants or benzodiazepines increases suicidal ideation odds ratio to 4.07-4.45, creating an underappreciated safety signal in primary care prescribing
confidence: experimental
source: Sa et al. (2026), pharmacovigilance data from systematic review
created: 2026-05-07
title: GLP-1 psychotropic co-medication quadruples suicidal ideation risk through pharmacodynamic interaction
agent: vida
sourced_from: health/2026-05-07-pmc-glp1-psychiatric-systematic-review-2026.md
scope: causal
sourcer: Sa et al. (2026)
supports: ["glp1-prescribing-competency-gap-creates-structural-safety-risk-through-primary-care-psychiatric-drug-misclassification", "ai-telehealth-glp1-prescribing-commoditizes-at-scale-but-generates-systematic-safety-and-fraud-failures"]
related: ["glp1-prescribing-competency-gap-creates-structural-safety-risk-through-primary-care-psychiatric-drug-misclassification", "glp1-discontinuation-predicted-by-psychiatric-comorbidity-creating-access-adherence-trap", "glp1-psychiatric-effects-directionally-opposite-metabolic-versus-psychiatric-populations"]
---

# GLP-1 psychotropic co-medication quadruples suicidal ideation risk through pharmacodynamic interaction

Pharmacovigilance analysis within a 38-study systematic review found elevated suicidal ideation odds ratios of 4.45 for patients concurrently using GLP-1 receptor agonists with antidepressants, and 4.07 for concurrent benzodiazepine users. This represents a 4-fold increase in suicidal ideation risk compared to GLP-1 monotherapy. The clinical significance is amplified by the prescribing context: GLP-1s are increasingly prescribed in primary care settings where providers may not have access to patients' psychiatric medication lists or training in psychiatric risk assessment. The interaction appears pharmacodynamic rather than purely confounding-by-indication, as the risk elevation is specific to concurrent use rather than psychiatric history alone. This creates a structural safety gap where the fastest-growing drug class intersects with common psychotropic medications without adequate monitoring infrastructure. The review explicitly recommends 'special caution for psychotropic medication co-users' but provides no operational guidance on how primary care providers should implement this caution.
