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A systematic review on the efficacy of GLP-1 receptor agonists in mitigating psychotropic drug-related weight gain

Published online by Cambridge University Press:  25 November 2024

Trisha Menon ,
Serene Lee ,
Xuan Yi Gong ,
Sabrina Wong ,
Gia Han Le ,
Angela T.H. Kwan ,
Kayla M. Teopiz ,
Roger Ho ,
Bing Cao Open the ORCID record for Bing Cao [Opens in a new window]  and
Taeho Greg Rhee
...Show all authors
Trisha Menon
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada Department of Psychology, University of Toronto, Toronto, Ontario, Canada
Serene Lee
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada Department of Health Sciences, Queen’s University, Kingston, Ontario, Canada
Xuan Yi Gong
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
Sabrina Wong
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
Gia Han Le
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
Angela T.H. Kwan
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
Kayla M. Teopiz
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
Roger Ho
Affiliation:
Department of Psychological Medicine, Yong Loo Lin School of Medicine, Singapore Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore Division of Life Science (LIFS), Hong Kong University of Science and Technology (HKUST), Clear Water Bay, Hong Kong, China
Bing Cao
Affiliation:
Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, P. R. China
Taeho Greg Rhee
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
Yang Jing Zheng
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
Kyle Valentino
Affiliation:
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
Kangguang Lin
Affiliation:
Department of Affective Disorder, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
Maj Vinberg
Affiliation:
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Heidi K.Y. Lo
Affiliation:
Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
Roger S. McIntyre*
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, ON, Canada
*
Corresponding author: Roger S. McIntyre; Email: [email protected]
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Abstract

Objective

Many psychotropic drugs are highly associated with related weight gain. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established anti-obesity and glucose-lowering agents. Preliminary evidence also indicates they are fit for purpose in mitigating psychotropic drug-related weight gain (PDWG). This systematic review aims to synthesize the extant evidence from randomized controlled trials (RCTs) on the effects of GLP-1RAs on weight change in persons experiencing PDWG.

Methods

Online databases (ie, PubMed, OVID Medline, Google Scholar) were searched to identify relevant studies from inception to January 1, 2024. Articles were screened by title, abstract, and full-text by three independent reviewers against inclusion and exclusion criteria.

Results

We identified six studies with participants aged ≥18 (n=374) that were eligible for inclusion in our systematic review. Most studies reported a significant and clinically meaningful effect of GLP-1RAs on anthropometrics and/or metabolics. All RCTs replicated the finding of modest or greater effects of GLP-1RAs; the most studied agents were liraglutide and exenatide. There was insufficient literature to conduct a meta-analysis.

Conclusion

Evidence suggests that GLP-1RAs are effective in mitigating weight gain in persons prescribed psychiatric medication. It is hypothesized that GLP-1RAs may moderate weight change in persons prescribed psychiatric medication through direct effects on metabolism and cognitive processes implicated in hunger/satiety. Future studies should aim to explore the long-term safety, tolerability, and efficacy profiles of various GLP-1RAs in the treatment and prevention of abnormal weight and metabolic homeostasis in psychiatric populations.

Keywords

schizophreniapsychotropic drug-related weight gainglucagon-like peptide-1 receptor agonistliraglutideexenatidedepressionbipolar disorderGLP-1dulaglutidesemaglutide
Type
Review
Information
CNS Spectrums , Volume 29 , Issue 5 , October 2024 , pp. 347 - 353
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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Footnotes

T.M., S.L., and X.Y.G. denotes co-first authorship.

This article has been updated since it was originally published. A notice detailing this has been published.

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