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Glucagon-like peptide-1 receptor agonists in patients treated with antipsychotics

Published online by Cambridge University Press:  13 August 2021

A. Delgado ,
J. Velosa ,
R. Avelar ,
J. Franco  and
M. Heitor
A. Delgado*
Affiliation:
Psychiatry, Hospital Beatriz Angelo, Loures, Portugal
J. Velosa
Affiliation:
Psychiatry, Hospital Beatriz Angelo, Loures, Portugal
R. Avelar
Affiliation:
Psychiatry, Hospital Beatriz Angelo, Loures, Portugal
J. Franco
Affiliation:
Psychiatry, Hospital Beatriz Angelo, Loures, Portugal
M. Heitor
Affiliation:
Psychiatry, Hospital Beatriz Angelo, Loures, Portugal
*
*Corresponding author.

Abstract

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Introduction

Glucagon-like peptide-1 (GLP-1) is an endogenous peptide that stimulates insulin secretion and decreases glucagon secretion. The use of GLP-1 receptor agonists (GLP-1RA) showed efficacy reducing the weight and glucose levels in patients with and without type 2 diabetes. This effect was also associated with a decreased risk of major cardiovascular events.

Objectives

Our aim is to review the role of GLP-1RA in psychiatric patients at cardio-metabolic risk due to antipsychotics treatment.

Methods

We reviewed articles published in PubMed using the keywords: “GLP-1” “glucagon like peptide” “antipsychotics” and “psychiatry”.

Results

The number need to treat (NNT) to achieve clinical meaningful weight loss was 3.8. GLP-1RA treatment was also associated with greater reductions in body mass index, fasting glucose, HbA1c and visceral fat. This effect is true for antipsychotic treatment in general and for those on clozapine and olanzapine in particular. Overall, the GLP-1RA are well tolerated with nausea being the most common related adverse effect. Other variables such as age, sex, psychosis severity, nausea or any adverse drug reaction did not affect the weight loss.

Conclusions

Studies showed a promising role in the management of antipsychotics induced weight gain, particularly in clozapine and olanzapine treated patients. Although these promising results, the route of administration, with a daily or weekly subcutaneous injection, and the GLP-1RA associated financial costs, can be viewed as important factors which can limit the wide use of this type of treatment in psychiatric patients.

Disclosure

No significant relationships.

Keywords

GLP-1RAglucagon like peptideobesityAntipsychotics
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S775
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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