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Peer-reviewedCC BYFrontiers in drug safety and regulation

Case Report: Panic attacks after tirzepatide injection in two female patients with recurrent depressive disorder.

  • Ulrich Palm1,2
  • Markus Backmund1,2,3
  • Hubertus Himmerich4,5
5 affiliations
  1. 1P3 Klinik, Private Clinic for Psychiatry, Psychotherapy and Psychosomatics, Tutzing, Germany.
  2. 2Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany.
  3. 3PIT, Praxiszentrum im Tal, Munich, Germany.
  4. 4Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
  5. 5South London and Maudsley NHS Foundation Trust, London, United Kingdom.
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Abstract

Tirzepatide was introduced several years ago for the management of obesity. Its side-effect profile includes gastrointestinal symptoms and hormonal shifts similar to other glucagon-like peptide-1 receptor agonists (GLP-1RAs). This class of medications is currently being investigated for its potential utility in treating depressive and anxiety disorders. While safety data generally indicate a low risk for adverse psychiatric events - such as suicidal ideation or depressive episodes - and some evidence suggests a beneficial impact on mood, anecdotal reports have linked these agents to panic attacks. However, scientific evidence for this remains limited. We present the cases of two female patients with histories of depressive disorder who experienced panic attacks following tirzepatide injections for weight loss. Both required hospitalization for the exacerbation of moderate-to-severe recurrent depressive disorder. The panic attacks occurred in close temporal proximity to the injections and resolved upon discontinuation. No clear medical aetiology was identified. Changes in pharmacokinetics by delayed gastric emptying, GABAergic deficits, an activation of the nucleus of the solitary tract (NTS) or activation of the hypothalamus-pituitary-adrenal axis are considered as potential mechanisms for panic attacks.

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Cite

BibTeXRIS
BibTeX
@article{palm2026case,
  title = {{Case Report: Panic attacks after tirzepatide injection in two female patients with recurrent depressive disorder.}},
  author = {Ulrich Palm and Markus Backmund and Hubertus Himmerich},
  journal = {Frontiers in drug safety and regulation},
  year = {2026},
  month = oct,
  doi = {10.3389/fdsfr.2026.1880796},
  url = {https://europepmc.org/article/MED/42909188},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Case Report: Panic attacks after tirzepatide injection in two female patients with recurrent depressive disorder.
AU  - Ulrich Palm
AU  - Markus Backmund
AU  - Hubertus Himmerich
PY  - 2026
DA  - 2026/10/07
JO  - Frontiers in drug safety and regulation
DO  - 10.3389/fdsfr.2026.1880796
UR  - https://europepmc.org/article/MED/42909188
AB  - Tirzepatide was introduced several years ago for the management of obesity. Its side-effect profile includes gastrointestinal symptoms and hormonal shifts similar to other glucagon-like peptide-1 receptor agonists (GLP-1RAs). This class of medications is currently being investigated for its potential utility in treating depressive and anxiety disorders. While safety data generally indicate a low risk for adverse psychiatric events - such as suicidal ideation or depressive episodes - and some evidence suggests a beneficial impact on mood, anecdotal reports have linked these agents to panic attacks. However, scientific evidence for this remains limited. We present the cases of two female patients with histories of depressive disorder who experienced panic attacks following tirzepatide injections for weight loss. Both required hospitalization for the exacerbation of moderate-to-severe recurrent depressive disorder. The panic attacks occurred in close temporal proximity to the injections and resolved upon discontinuation. No clear medical aetiology was identified. Changes in pharmacokinetics by delayed gastric emptying, GABAergic deficits, an activation of the nucleus of the solitary tract (NTS) or activation of the hypothalamus-pituitary-adrenal axis are considered as potential mechanisms for panic attacks.
SN  - 2674-0869
ER  -