Does Victoza cause depression? This question concerns many people prescribed liraglutide for type 2 diabetes management. Whilst there is currently no established causal link between Victoza and depression in regulatory guidance, some patients report mood changes during treatment. Understanding the relationship between diabetes medications and mental health is essential, as people with diabetes already face twice the risk of depression compared to the general population. This article examines the evidence, explores potential contributing factors, and provides practical guidance on recognising and managing mood changes whilst taking Victoza.

What Is Victoza and How Does It Work?

Victoza (liraglutide) is a prescription medicine licensed in the UK for the treatment of type 2 diabetes mellitus in adults and children aged 10 years and above. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of a naturally occurring hormone in the body that helps regulate blood sugar levels.

The mechanism of action involves several complementary effects. Victoza stimulates insulin secretion from the pancreas when blood glucose levels are elevated, whilst simultaneously suppressing the release of glucagon, a hormone that raises blood sugar. Additionally, it slows gastric emptying, which helps reduce post-meal glucose spikes, and may promote a feeling of fullness that can assist with weight management—a beneficial effect for many people with type 2 diabetes.

Victoza is administered as a once-daily subcutaneous injection using a pre-filled pen device. The usual starting dose is 0.6 mg daily, which is typically increased to 1.2 mg after at least one week. Some patients may benefit from a further increase to 1.8 mg daily, depending on glycaemic control and tolerability. The medication is often prescribed alongside other diabetes treatments such as metformin, sulphonylureas, or insulin. When combined with sulphonylureas or insulin, there is an increased risk of hypoglycaemia, and dose reductions of these medications may be needed.

Common side effects include gastrointestinal symptoms such as nausea, vomiting, diarrhoea, and constipation, which often improve over time. More serious but rare adverse effects can include pancreatitis. If you experience severe, persistent abdominal pain (which may radiate to the back), with or without vomiting, stop taking Victoza and seek urgent medical attention. In animal studies, liraglutide has been associated with thyroid C-cell tumours, although the relevance to humans is uncertain. You should report any unusual neck symptoms such as a lump, difficulty swallowing, or persistent hoarseness to your doctor.

Recognising Mental Health Changes While Taking Victoza

The relationship between Victoza and depression remains an area of ongoing clinical observation and research. There is no official, established causal link between liraglutide and depression listed in the Summary of Product Characteristics (SmPC) approved by the MHRA or EMA. Recent regulatory reviews (2023-2024) by the EMA and MHRA have found no causal association between GLP-1 receptor agonists and suicidal ideation to date, though monitoring continues. However, some patients and healthcare professionals have reported mood changes, low mood, or depressive symptoms during treatment, prompting important discussions about monitoring mental health in people taking GLP-1 receptor agonists.

Several factors may contribute to mental health changes in people with type 2 diabetes taking Victoza. Living with a chronic condition like diabetes itself is associated with higher rates of depression and anxiety—research suggests that people with diabetes are approximately twice as likely to experience depression than the general population. The daily burden of managing blood glucose, dietary restrictions, medication regimens, and concerns about complications can significantly impact psychological wellbeing.

Additionally, fluctuations in blood sugar levels can directly affect mood and cognitive function. Both hypoglycaemia (low blood sugar) and hyperglycaemia (high blood sugar) can cause symptoms that overlap with depression, including fatigue, difficulty concentrating, irritability, and changes in sleep or appetite. When starting or adjusting Victoza, these metabolic changes may temporarily affect how someone feels emotionally.

It is important to recognise potential signs of depression, which may include:

• Persistent low mood or sadness lasting more than two weeks

• Loss of interest or pleasure in activities previously enjoyed

• Changes in appetite or weight (beyond expected effects of the medication)

• Sleep disturbances—either insomnia or excessive sleeping

• Fatigue or loss of energy

• Feelings of worthlessness or excessive guilt

• Difficulty concentrating or making decisions

• Thoughts of self-harm or suicide

If you experience thoughts of self-harm or suicide, seek immediate help by calling 999, going to A&E, contacting NHS 111, or calling the Samaritans on 116 123. For other symptoms, discuss them with your GP or diabetes specialist nurse. Distinguishing between medication effects, diabetes-related distress, and clinical depression requires careful clinical assessment.

What to Do If You Experience Low Mood on Victoza

If you develop symptoms of low mood or depression whilst taking Victoza, do not stop the medication abruptly without medical advice. Suddenly discontinuing diabetes treatment can lead to poor glycaemic control and potentially serious complications. Instead, contact your GP or diabetes care team promptly to discuss your symptoms and explore appropriate management options.

Your healthcare professional will likely conduct a comprehensive assessment to identify potential contributing factors. This may include:

• Reviewing your blood glucose patterns to identify hypoglycaemia or significant fluctuations

• Assessing other medications you are taking, as some drugs can affect mood

• Evaluating recent life stressors or changes in circumstances

• Screening for clinical depression using validated tools such as the PHQ-9 questionnaire

• Checking thyroid function and other relevant blood tests, as thyroid disorders can cause mood symptoms

Depending on the assessment findings, several management approaches may be considered. If blood glucose instability is identified as a contributing factor, your clinician may consider adjusting your diabetes treatment regimen, including Victoza dosing or timing, modifying other diabetes medications, or refining your dietary approach to help stabilise both glucose and mood. Your diabetes team can provide guidance on recognising and managing hypoglycaemia, which is particularly important if you are taking Victoza alongside insulin or sulphonylureas.

If clinical depression is diagnosed, evidence-based treatments should be initiated according to NICE guidelines. These typically include psychological therapies such as cognitive behavioural therapy (CBT) or counselling, which can be accessed through NHS Talking Therapies services. For moderate to severe depression, antidepressant medication may be recommended alongside psychological support. Most antidepressants can be safely used with Victoza, though your doctor will consider any potential interactions.

In some cases, if symptoms are clearly temporally related to starting Victoza and other causes have been excluded, your doctor may discuss switching to an alternative diabetes medication. This decision should be made collaboratively, weighing the benefits of current glycaemic control against the impact on mental wellbeing.

If you experience severe depressive symptoms or thoughts of self-harm, seek urgent help by calling 999, attending A&E, contacting NHS 111, or calling the Samaritans on 116 123. Never feel that you must continue a medication that significantly affects your quality of life—there are usually alternative treatment options available.

Alternative Diabetes Treatments and Mental Health Considerations

If Victoza is not suitable due to concerns about mental health or other side effects, several alternative treatment options are available for managing type 2 diabetes. The choice of therapy should be individualised based on clinical factors including HbA1c levels, body weight, cardiovascular risk, renal function, and patient preferences—including considerations about mental wellbeing.

Metformin remains the first-line treatment for most people with type 2 diabetes according to NICE guidance. It works by reducing glucose production in the liver and improving insulin sensitivity. Metformin has a well-established safety profile and has no established link with depression. The main side effects are gastrointestinal, which can often be minimised by using modified-release formulations and gradual dose titration.

SGLT2 inhibitors (such as dapagliflozin, empagliflozin, and canagliflozin) represent another modern class of diabetes medications. These work by increasing glucose excretion through the urine and offer cardiovascular and renal protective benefits. They are generally well-tolerated, with the main side effects being increased urination and a higher risk of genital infections. There is no established link between SGLT2 inhibitors and mood disorders. However, they can rarely cause diabetic ketoacidosis (DKA), even with near-normal blood glucose levels.

DPP-4 inhibitors (such as sitagliptin, linagliptin, and saxagliptin) work through a mechanism related to GLP-1 agonists but are taken orally and have a different side effect profile. They are generally well-tolerated with minimal gastrointestinal effects and no known association with depression. However, they are less effective for weight reduction compared to GLP-1 agonists.

For some patients, traditional therapies such as sulphonylureas (gliclazide, glimepiride) or insulin may be appropriate. Whilst effective for glucose control, these medications carry a risk of hypoglycaemia and weight gain, which can indirectly affect mood and wellbeing.

When considering any diabetes treatment, it is important to discuss your mental health history and current psychological wellbeing with your healthcare team. Integrated diabetes care should address both physical and mental health needs. Many diabetes services now include access to psychological support, and healthcare professionals should routinely consider psychological wellbeing during diabetes reviews, with referral to appropriate support services when needed.

Remember that effective diabetes management and mental health support are not mutually exclusive—with the right combination of treatments and support, it is possible to achieve good glycaemic control whilst maintaining psychological wellbeing. If you have concerns about any aspect of your diabetes treatment, including its impact on your mood, speak openly with your healthcare team to find the most suitable approach for your individual circumstances.

If you experience any side effects while taking Victoza or other medications, report them to your healthcare professional and consider using the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk or the Yellow Card app).

Frequently Asked Questions