By the end of their first year on GLP-1, more than half of patients stop taking the drug.
There are several reasons for this, including high costs, unpleasant side effects and satisfaction from weight already lost. The trap: stop taking GLP-1 and the weight may come back quickly.
And that’s not all: Your mind may also suffer after stopping the vaccine, according to new reports.
Research is just beginning to uncover the psychiatric impacts of stopping a medication that could affect how the brain processes mood and rewards.
New case reports published in The Primary Care Companion for CNS Disorders detail the stories of two men who suffered psychiatric effects after stopping the weight-loss drug.
Hallucinations
A 61-year-old man stopped tirzepatide (sold under the brand names Mounjaro and Zepbound) in August 2025 due to nausea.
Two months later, he was hospitalized for increasing confusion and erratic behavior.
Doctors noted that he suffered from paranoia, auditory and visual hallucinations, and Cotard’s delusion, a condition in which the patient believes he is dead or does not exist. These symptoms met the criteria for a psychotic disorder.
Although he had a history of depression, his condition deteriorated significantly in the month before his hospitalization.
Tests of his spinal fluid, as well as brain MRIs and an electroencephalogram, all came back normal, ruling out several other causes. Doctors told him to continue taking his antidepressant (Zoloft) and gave him two more antipsychotics (Zyprexa and Haldol).
While his psychotic symptoms and depression initially improved enough for him to return home, he was readmitted weeks later for depression with catatonic features, becoming immobile and unresponsive.
Eventually he had to be hospitalized and was treated with electroshock.
Mania
A 52-year-old patient abruptly stopped the same medication (tirzepatide) in September 2025 after significant weight loss – he had lost 100 pounds in six months.
Barely a month later, he was admitted to the hospital for erratic behavior and mood swings.
Although he had a history of anxiety, his behavior after he stopped taking the drug was much more concerning and met the criteria for a manic episode. His symptoms included rapid, continuous, incoherent speech, impulsivity, irritability and grandiosity – an unrealistic feeling of uniqueness, power or superiority.
Mania can be dangerous, especially because the patient may feel invincible and expose themselves to dangerous situations such as reckless driving. Additionally, excess energy combined with a lack of sleep and food can put extreme strain on the body.
Once again, her test results came back normal, aside from a low vitamin B12 level. He was given the antipsychotic drug Risperdal and transferred to a psychiatric facility.
What is happening?
GLP-1 doesn’t just work on your digestive system: it also penetrates deep into the brain.
Research from the University of Virginia suggests that the drugs affect a brain circuit involved in emotion processing, specifically how the brain rewards eating high-calorie foods with dopamine, the neurohormone that stimulates motivation, desire and pleasure.
“These medications impact neurotransmitters and therefore can impact mood,” Amy Walters, a psychotherapist who works with people with metabolic diseases, told the American Psychological Association.
The authors of both case studies note that sudden mood or psychotic symptoms after stopping the drug could be “an underestimated clinical phenomenon,” calling for more attention and research into exactly how GLP-1 affects our brains.
They suggest the drugs could cause central nervous system inflammation, affect dopamine production and contribute to psychotic symptoms in at-risk patients.
The authors also point out that both patients had a history of mental health problems (depression and anxiety, respectively), which could play a role in the appearance of these symptoms.
Ultimately, they urge doctors to be aware of this potential side effect when patients stop treatment.
Gn Health
