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62 Collectively, the evidence supports a mechanism-informed, risk-stratified clinical approach that prioritises gradual dose escalation, anticipatory counselling, functional monitoring, and targeted vigilance in susceptible subgroups, while recognising persistent evidence gaps and the need for long-term, high-quality, real-world safety data to characterise uncommon and delayed adverse outcomes associated with GLP-1 receptor agonists

However, sensitivity analyses indicated that the overall effect was robust, suggesting that this risk signal was not driven by any single study but might reflect the true variable effects of GLP 1RA on mental health across different populations and study designs

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Both semaglutide and tirzepatide are glycemic controlling medications