GLP-1 Receptor Agonists as a Novel Solution for Antipsychotic-Induced Weight Gain in Severe and Persistent Mental Illness.

Abstract

Patients with severe and persistent mental illness (SPMI) experience significant metabolic side effects from antipsychotic medications, including antipsychotic-induced weight gain (AIWG). This contributes to a high prevalence of obesity, insulin resistance, and type 2 diabetes in this population, ultimately reducing life expectancy. Traditional weight management strategies, such as behavioural interventions, are often less feasible in this group. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for type 2 diabetes, have shown promise in addressing AIWG by reducing weight, improving metabolic parameters, and offering potential neuroprotective and psychiatric benefits. Evidence supports the efficacy of GLP-1RAs in managing AIWG, with studies demonstrating substantial reductions in weight and body mass index without exacerbating psychiatric symptoms. However, access to these medications remains limited due to high costs and restrictive healthcare policies. Expanding access to GLP-1RAs could bridge a critical gap in care for patients with SPMI, improving both physical and mental health outcomes. Future research should focus on evaluating long-term efficacy and cost-effectiveness, particularly in the Canadian healthcare context, to inform policy changes and optimize treatment strategies.