New Research on Addressing Metabolic Issues Associated With Antipsychotics at APA Annual Meeting

CONFERENCE REPORTER

GLP-1 receptor agonists may offer an important new tool for psychiatric clinicians managing metabolic risks associated with antipsychotics, according to a literature review presented at the 2025 American Psychiatric Association Annual Meeting in Los Angeles, California.^1,2

Amir Meftah, MD, a PGY-2 resident at One Brooklyn Health Interfaith Medical Center, and colleagues, conducted a systematic review of the literature to ascertain how GLP-1 receptor agonists may mitigate the cardiometabolic complications commonly associated with antipsychotic treatments.

For the review, Meftah et al identified 2 randomized clinical trials, 1 case report, and 1 retrospective study examining GLP-1 agonists in patients taking the antipsychotics clozapine or olanzapine. In 1 randomized controlled study, investigators found liraglutide significantly improved glucose tolerance in patients with schizophrenia spectrum disorders who were being treated with olanzapine or clozapine (N=103; p < .001). More patients who received liraglutide achieved normal glucose tolerance than those who received the placebo 63.8% vs 16.0%, respectively). Patients also in the active treatment group also saw reduced body weight, waist circumference, blood pressure, visceral fat, and LDL cholesterol levels. The other studies showed similar positive results.

In an exclusive interview with Psychiatric Times, Meftah said he was pleased with the findings. “These studies show that this medication can reduce body weight, reduce the BMI, and reduce the waist circumferences,” he reported. “And it helps to help improve the glucose tolerance and insulin tolerance and help to improve the glycemic control or hemoglobin A1C, which is a great news for field of psychiatry.”

None of the studies reported dropouts as a result of the adverse events associated with GLP-1 agonists, Meftah added.

Considering the burden of metabolic effects and the anecdotal comments from colleagues who are using these agents with antipsychotics , Meftah is cautiously encouraged by these findings,

“We definitely need bigger randomized clinical trials,” he said, noting that the current evidence, though limited, suggests real potential for improving outcomes in patients at high metabolic risk.

“This medication can reduce body weight, BMI, and waist circumference. It also helps improve glucose tolerance, insulin tolerance, and hemoglobin A1c levels,” all of which may impact the quality of life of patients.

References

1. Lawrence J, Meftah A, Efremoff S, et al. Potential of Glp-1 agonists in mitigating metabolic side effects associated with clozapine or olanzapine therapy: literature review. Presented at the 2025 American Psychiatric Association Annual Meeting; May 17 -21, 2025; Los Angeles, California.

2. Miller B. Antipsychotic Polypharmacy and Metabolic Disorder Risk in Individuals With Schizophrenia. Psychiatric Times. 2023;40(12):30.