Some people taking GLP-1 medications report feeling more anxious; others report the opposite or no change at all. Research so far is limited, and findings across studies have been mixed. No clear consensus has emerged. What researchers have found is not the same as what will happen to you — that part belongs in a conversation with your provider.
What Has Research Found About GLP-1 and Anxiety?
Research on GLP-1 medications and anxiety is still in early stages, and results across studies have been mixed. As of September 2026, we did not find a clear, consistent direction in the published literature — some studies report improvement in anxiety-related measures, others report worsening or new symptoms, and others report no meaningful difference.
A 2025 systematic review published in Brain and Behavior (Meshkat Shakila et al., PMC12241715) examined psychiatric outcomes across 26 studies involving more than 3,000 participants. The review concluded that "GLP-1 RAs showed mixed and inconclusive effects on psychiatric symptoms. Although some studies suggested potential benefits, others reported null findings," and that "current evidence remains insufficient to determine whether GLP-1 RAs have a definitive therapeutic effect" on anxiety or other psychiatric symptoms.
A 2026 systematic review (Tian Yi Yu et al., Psychoneuroendocrinology, DOI 10.1016/j.psyneuen.2026.107844) examined GLP-1 receptor agonists and anxiety specifically — a more focused scope than much prior work on psychiatric outcomes broadly. As of September 2026, we did not have access to the full text of that review; it is included in our References for context.
If you are noticing changes in how you feel emotionally since starting GLP-1 treatment — including experiences that go beyond anxiety — our piece on emotional changes and GLP-1 medications covers a broader range of what people have reported and what researchers are exploring.
What Possible Explanations Are Researchers Exploring?
GLP-1 receptors are found not only in the gut and pancreas but also in brain regions involved in stress response, motivation, and emotional regulation — including the amygdala, hippocampus, and hypothalamus. This distribution is part of why researchers are investigating whether GLP-1 medications might influence mood or anxiety.
One area of active inquiry involves serotonin signaling. Some researchers hypothesize that GLP-1 receptor activity in these brain areas may interact with pathways associated with mood and anxiety regulation. Others are examining the gut-brain axis: GLP-1 medications produce significant changes in appetite and digestion, and the relationship between gut signaling and emotional states is a growing area of neuroscience research. Dopamine and cortisol responses are also under investigation.
These are hypotheses being explored in research settings — not confirmed mechanisms. The neuroscience of anxiety is complex, and a clear picture of how GLP-1 medications fit into it has not yet emerged. For more detail on what researchers currently understand about GLP-1 receptors and the brain, see our piece on emotional changes and GLP-1 medications.
These mechanisms are studied in research settings and do not predict what any individual will experience.
What Have Clinical Trials and Studies Reported?
The clinical evidence on GLP-1 medications and anxiety comes from several types of research: randomized controlled trials that included mood as a secondary outcome, pharmacovigilance databases tracking real-world adverse event reports, and retrospective registry studies. Results have varied depending on the study type, population, medication, and the way anxiety was measured.
What clinical trials have measured
The 2025 systematic review by Meshkat Shakila et al. included nine randomized controlled trials that assessed psychiatric outcomes. Results were heterogeneous. In one trial, semaglutide was associated with improvements in a diabetes-related quality-of-life subscale that included an anxiety component, with a standardized effect size of Cohen's d = 0.48. Other trials reported no significant change in anxiety measures. The authors noted that differences in medication type, dose, study population, follow-up duration, and measurement tools made it difficult to draw generalizable conclusions.
What pharmacovigilance databases have captured
A 2024 pharmacovigilance study by Tobaiqy Mansour et al., published in the International Journal of Clinical Pharmacy (PMC10960895), analyzed adverse event reports submitted to EudraVigilance — the European Medicines Agency's centralized database — for semaglutide, liraglutide, and tirzepatide from January 2021 through May 2023. Of the 31,444 adverse event reports analyzed, 372 (approximately 1.2%) were classified as psychiatric events. Among those psychiatric reports, anxiety was the second most commonly documented, accounting for 144 of the 372 psychiatric adverse event reports (38.7%).
Pharmacovigilance databases collect reports that were voluntarily submitted — not controlled observations of everyone taking these medications. A report in such a database does not establish that a medication caused a symptom; it documents that someone reported both occurring at the same time. These systems are designed to detect signals that may warrant closer examination, not to establish causation.
These were outcomes reported through an adverse event surveillance system — not a checklist for self-diagnosis. Symptom evaluation requires a qualified provider.
Whether to continue, adjust, or stop medication based on anxiety symptoms is a decision for you and your provider — not a conclusion from any single study.
If you are ever unsure whether what you are experiencing is something to raise now versus wait on, our piece on when to call your doctor about GLP-1 side effects outlines the kinds of changes worth bringing to a provider's attention.
How Is Feeling Anxious Different From a Diagnosed Anxiety Disorder?
Feeling more on-edge or anxious while taking a GLP-1 medication is not the same as having a clinical anxiety disorder — the latter is a medical diagnosis that requires professional evaluation, not self-assessment.
Clinical anxiety disorders — including generalized anxiety disorder, panic disorder, social anxiety disorder, and others — are diagnosed by qualified clinicians using specific criteria that assess the nature, duration, severity, and functional impact of symptoms. Many people experience periods of heightened worry, restlessness, or nervous energy during significant life changes, health adjustments, or medication transitions. These experiences are real and can be uncomfortable, but they are not equivalent to a clinical diagnosis.
People with pre-existing anxiety diagnoses, depression, or other mental health conditions may want to pay particular attention to any changes they notice after starting or adjusting GLP-1 treatment — and bring those observations to both their prescribing provider and their mental health provider. This overlap between GLP-1 medications and mental health conditions is an emerging area of clinical interest; our piece on GLP-1 medications and ADHD explores a related area where psychiatric and metabolic care intersect.
These feelings — while real and uncomfortable — require professional evaluation to understand what is going on for you specifically.
If anxiety is affecting your daily life, work, or relationships, a mental health professional — not this article — is the right resource.
If you are in crisis or thinking about harming yourself, you don't have to wait. In the U.S., call or text the 988 Suicide & Crisis Lifeline (988) anytime, day or night. If you're facing a medical emergency, call 911.
What Does 'Mixed Evidence' Mean for GLP-1 Users?
When researchers describe the evidence on GLP-1 medications and anxiety as "mixed," they mean that studies have not consistently pointed in the same direction — some report improvements, some report worsening, and some report no meaningful difference. This inconsistency reflects the early state of this research area, not a settled picture.
Mixed evidence arises for many reasons. Studies have used different medications at different doses, enrolled different patient populations, followed participants for different lengths of time, and used different tools to measure anxiety. Until research can control for these variables more consistently, drawing broad conclusions is difficult.
Regulatory bodies including the U.S. Food and Drug Administration (FDA) have monitored safety signals for GLP-1 medications, including reports of changes in mood. A 2024 peer-reviewed analysis by Zhou Jianxing et al., published in BMC Medicine (PMC10865629), examined reports in the FDA Adverse Event Reporting System (FAERS) and found no signal of disproportionate reporting of an association between GLP-1 receptor agonist use and suicidal or self-injurious behaviors. That study's primary focus was on that specific outcome; anxiety broadly was not the primary object of analysis.
Additional contributions to this field include a 2026 study by Taipale Heidi et al., published in The Lancet Psychiatry (DOI 10.1016/s2215-0366(26)00014-3), and a 2026 study by Hung Tsung-Hsuan et al., published in Human Psychopharmacology (DOI 10.1002/hup.70041). Both are cited in our References; as of September 2026, we did not have access to the full text of either study.
Mixed evidence means the question is not yet answered — not that anxiety is unimportant. If you are experiencing anxiety, that is worth discussing with your provider regardless of what studies show.
Some people on GLP-1 medications also notice disruptions to sleep — including difficulty staying asleep or a heightened sense of alertness at night — which can in turn affect how anxious or on-edge they feel. Research on GLP-1 medications and sleep is also early and mixed. Our piece on GLP-1 and sleep problems covers what is currently understood.
What Can You Bring to Your Provider From This Research?
This article describes what researchers have examined and found — not what you should do about it. What approach, if any, fits your situation is a conversation for your provider, not a conclusion from a research article.
If you have noticed changes in how you feel since starting or adjusting a GLP-1 medication, the most useful thing you can bring to an appointment is a specific description: when it started, how often it happens, how intense it feels, and how much it affects your daily routine. General impressions tend to be harder to act on than specific observations.
Questions that some people find useful to bring to their provider:
- I have noticed [specific experience] since starting this medication — is that something worth tracking together?
- Could what I'm feeling be related to my medication, something else in my health history, or a combination of factors?
- Is this a reason to involve a mental health professional in addition to my primary care provider?
- What would be a reason to reach out before my next scheduled appointment?
The GLP-1 Side-Effect & Progress Tracker is designed to help you log how you are feeling between appointments — including changes in mood, anxiety, and sleep — so that what you bring to your provider is based on consistent records rather than memory. A log from even a few weeks can help your provider see patterns that would otherwise be easy to miss.
Our piece on talking to your doctor about GLP-1 offers practical suggestions for making those conversations more productive, including how to describe symptoms clearly and what information providers often find most useful.
This article describes research findings, not management recommendations. What approach — if any — fits your situation is a conversation for your provider.
If anxiety — or any significant change in how you feel — is affecting your ability to function day to day, a mental health professional is the right resource to involve. You do not need to wait until your next scheduled visit. The tracker is free, private, and stores nothing on a server.
Disclaimer: For informational purposes only. Not medical advice. Consult your healthcare provider. If you or someone you know is in crisis, call or text the 988 Suicide & Crisis Lifeline. If you are experiencing a medical emergency, call 911.