GLP Medications & Panic and Anxiety

"Why Am I Suddenly So Anxious?"

I can’t tell you how many times patients come to therapy and say something like, "I don’t know what’s wrong with me. I feel fine one minute, and then out of nowhere, my heart is racing, I can’t breathe, and I feel like something terrible is about to happen."

For many, anxiety has been a lifelong companion. But when someone without a history of panic attacks suddenly starts experiencing them, we start digging deeper. What changed? New stressors? A change in routine? Maybe a new medication?

As we start ruling things out, we often land on a class of medications many don’t expect: GLP-1 receptor agonists.

The Unexpected Link Between GLP-1 Medications and Anxiety

GLP-1 medications—like Ozempic, Wegovy, Saxenda, Victoza, Mounjaro, and Zepbound—are widely used for diabetes management and weight loss. While they help regulate blood sugar and control appetite, they can also trigger panic attacks and anxiety in some people. Let’s break down why.

How GLP-1 Medications Might Be Fueling Your Anxiety

1. Blood Sugar Fluctuations & Hypoglycemia

One of the first things we check when unexplained anxiety shows up is blood sugar levels. GLP-1 medications stimulate insulin release and slow down digestion, which can sometimes lead to low blood sugar (hypoglycemia). The symptoms of hypoglycemia—shakiness, dizziness, sweating, and a racing heart—can feel almost identical to a panic attack. If your body suddenly feels like it's in distress, your brain may interpret it as anxiety, even when there’s no emotional trigger.

2. Delayed Absorption of Anxiety Medications

These medications slow down gastric emptying, which means that any medication you take—including antidepressants, benzodiazepines, and beta-blockers—might not be absorbed as effectively. If you’re on something for anxiety or panic disorder, but your body isn’t processing it the same way, you might feel like your medication isn’t working as well anymore. Cue increased anxiety.

3. Changes in Neurotransmitter Activity

GLP-1 receptors are found not just in the pancreas, but also in the brain. These medications influence dopamine, serotonin, and GABA levels—all of which are critical for mood regulation. Some people might experience increased stress responses, disrupted serotonin balance, or a heightened sensitivity to stress.

4. Dehydration & Electrolyte Imbalance

Nausea, vomiting, and diarrhea are common side effects of GLP-1 medications, leading to dehydration and loss of electrolytes. Low levels of potassium and magnesium can make the nervous system more excitable, which can contribute to anxiety symptoms and even heart palpitations.

"What Can I Do If My GLP-1 Meds Are Making Me Anxious?"

If you suspect your medication is contributing to your anxiety, don’t panic (pun intended). There are ways to manage it:

1. Track Your Symptoms

Keep a journal of when your anxiety spikes. Does it happen after taking your medication? Before meals? After eating? Identifying a pattern can help you and your doctor adjust your approach.

2. Stabilize Blood Sugar

Eat small, balanced meals throughout the day to prevent dips in blood sugar.

Avoid excess caffeine and alcohol, which can make anxiety worse.

If you feel shaky or lightheaded, try a quick carb like fruit or a small snack.

3. Adjust Medication Timing

Talk to your doctor about adjusting the timing of your anxiety medications to improve absorption.

Consider liquid or sublingual versions of your medications to bypass the digestive slowdown.

4. Hydrate & Replenish Electrolytes

Drink plenty of water throughout the day.

Incorporate foods rich in potassium (bananas, avocados) and magnesium (nuts, leafy greens).

If nausea is an issue, try electrolyte drinks to keep your body balanced.

5. Work With a Professional

If anxiety is becoming overwhelming, don't suffer in silence. A therapist or psychiatrist can help you navigate medication side effects and develop strategies to manage anxiety. Sometimes a simple medication adjustment can make a world of difference.

Final Thoughts

GLP-1 medications have incredible benefits, but they affect more than just blood sugar and weight. If you’re experiencing new or worsened anxiety, don’t ignore it—you’re not imagining things. It might just be your body adjusting to a powerful medication.

The key is to listen to your body, track changes, and communicate with your doctor. With the right adjustments, you can manage your anxiety without giving up on the health benefits these medications may offer.

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