These numbers describe reports, not people. That distinction is the whole article, and it is set out at length in the piece on the FDA’s database, which runs a different comparison on a different system.
What was counted
Every European case safety report from 2021 through 2025 naming one of the three drugs as suspect, where the indication was diabetes or weight management. [1] That came to 42,941 reports. Gastrointestinal problems dominated, as they always do for this class.
Suicide and self-injury events were a small share: 37, 141 and 47 cases across the three drugs. 225 in total.
The comparison
The reference drug is tirzepatide. Not placebo, not every other medicine in the database — tirzepatide.
Against it, semaglutide carried these events 2.69 times as often among its reports, 95% CI 1.91 to 3.83. Liraglutide, 2.54 times, 95% CI 1.60 to 4.01.
What else runs the same direction
Liraglutide has been sold since 2010, semaglutide since 2018, tirzepatide since 2022. Older drugs accumulate reports.
And the suicidality question was a headline about semaglutide in particular. People report what they have been told to watch for, which pharmacovigilance calls notoriety bias and which is the standing weakness of every spontaneous system.
What regulators found
European and US agencies have both examined this and neither has confirmed a causal relationship. The authors note that their results do not contradict that.
A large matched cohort published separately pointed the other way, associating semaglutide with lower neuropsychiatric event rates — though that study published no effect sizes at all. Neither design settles it.
What a buyer does with it
Not choose a molecule on this. The two drugs differ on weight and on price in ways that are measured; they do not differ here in any way a rate could confirm.
If you are taking one of these and having thoughts of harming yourself, that is a conversation to have with a doctor now, not a number to weigh. Continued monitoring is what the authors ask for, and it is the right ask.