Anhedonia as a side-effect of semaglutide.

Anecdotal evidence only. I hope this might be useful for someone, especially that semaglutide is often considered a sort of miracle drug (and for good reasons). TL;DR:

• I had pretty severe anhedonia for the last couple months
• It started when I started taking semaglutide. I've never had anything like that before and I have no idea for possible other causes.
• It mostly went away now that I decreased the dose.
• There are other people on the internet claiming this is totally a thing

My experience with semaglutide

I've been taking Rybelsus (with medical supervision, just for weight loss, not diabetes). Started in the last days of December 2024 - 3mg for a month, 7mg for 2 months, then 14mg until 3 weeks ago when I went back to 7mg. This is, I think, a pretty standard path.

It worked great for weight loss - I went from 98kg to 87kg in 9 months with literally zero effort - I ate what I wanted, whenever I wanted, just ate less because I didn't want to eat as much as before. Also, almost no physiological side-effects.

I don't remember exactly when the symptoms started, but I think they were pretty signifiant around the beginning of March and didn't improve much until roughly a few days after I decreased the dose.

What I mean by anhedonia

First, I noticed that work is no longer fun (and it was fun for the previous 2 years). I considered burnout. But it didn't really look like burnout.
Then, I considered depression. But I had no other depression symptoms.
My therapist explicitly called it more than once "anhedonia with unknown causes" so this is not only a self-diagnosis.

Some random memories:

• Waking up on Saturday thinking "What now. I can do so many things. I don't feeling like doing anything."
• Doing things that always caused feeling of joy and pleasure (attending a concert, hiking, traveling in remote places etc) and thinking "what happened to that feeling, I should feel joy now".
  • More specific: this was really weird. Like, e.g. on a recent concert - I felt I really enjoy the music  on some level (had all the good stuff like "being fully there and focused on the performance", lasting feeling "this was better than expected" etc), it was only that the deep feeling of pleasure/joy was missing.
• All my life I've always had something I wanted to do if I had more time - could be playing computer games, could be implementing a solution for ARC AGI, designing boardgames, recently mostly work. Not feeling that way was super weird.
• Playing computer games that were always pretty addictive ("just one more round ... oops how is it now 3am?") with a feeling "meh, I don't care".

Other people claim similar things

See this reddit thread. You can also google "ozempic personality" - but I think this is rarely about just pure anhedonia. 

Some random thoughts

(NOTE: All non-personal observations here are low quality and an LLM with deep search will do better)

• Most studies show GPL-1 agonists don't affect mood. But not all - see here.
  • (Not sure if makes sense) Losing weight is great. You are prettier and fit and this is something you wanted. So the mood should improve in some people - therefore perhaps null result in population implies negative effects on some other people?
• I have ADHD. People with ADHD often have different dopamine pathways. Semaglutide affects dopamine neurons. So there's some chance these things are related. Also I think there are quite many ADHD reports in the reddit thread I linked above.
• People claim it's easier to stop e.g. smoking or drinking while on semaglutide. So this suggests a general "I don't need things". This seems related.