Efficacy and safety of GLP-1 receptor agonists for antipsychotic-related overweight and metabolic dysregulation: a systematic review and meta-analysis.

Lingyan Zhou, Ying Zhang, Chao Shen, Fengbo Wu

Abstract readSystematic ReviewMeta-Analysis

In one paragraph

Synthesis in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Lingyan ZhouDepartment of Pharmacy, West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, 610041, China.

Ying ZhangDepartment of Pharmacy, West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, 610041, China.

Chao ShenDepartment of Pharmacy, West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, 610041, China.

Fengbo WuDepartment of Pharmacy, West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, 610041, China. zhangy8395@wchscu.cn.

Funding

Chengdu Pharmaceutical Association Cdyxky8006Sichuan Provincial Science and Technology Support Program 2024JDKP0145

6 · The paper itself

Abstract

backgroundAntipsychotic-related overweight and metabolic dysregulation are highly prevalent among patients with severe mental illness. Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated substantial metabolic benefits in the general population, their efficacy and safety in antipsychotic-treated patients remain unclear. This review aimed to systematically evaluate the efficacy and safety of GLP-1RAs in patients with antipsychotic-related overweight and metabolic dysregulation.

methodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating GLP-1RAs in adults receiving antipsychotic treatment. PubMed, Web of Science, Embase, MEDLINE, the Cochrane Library, and ClinicalTrials.gov were searched from inception to September 13, 2026. Primary outcomes included changes in body weight, body mass index (BMI), HbA1c, and total cholesterol. Random-effects models were used to pool mean differences (MDs) and risk ratios (RRs). This study was registered with PROSPERO (CRD420261290294).

resultsEight RCTs involving 535 randomized participants were included. GLP-1RAs treatment was associated with significant reductions in body weight (MD = -6.54 kg, 95% CI: -9.80 to -3.29, P < 0.001, I

conclusionGLP-1RAs significantly improve weight-related and glycemic outcomes in antipsychotic-treated patients, at the cost of an increased risk of gastrointestinal adverse events. Their psychiatric safety could not be established owing to sparse data. Longer-term trials with standardized safety reporting are warranted.

Indexed as

Antipsychotic AgentsGlucagon-Like Peptide-1 Receptor AgonistsMetabolic DiseasesOverweightGlycated HemoglobinHumansRandomized Controlled Trials as TopicSemaglutideAntipsychotic AgentsGlucagon-Like Peptide-1 Receptor AgonistsGlycated HemoglobinSemaglutideAntipsychoticGlucagon-like peptide-1 receptor agonistsMetabolic dysregulationOverweight

Identifiers

PMID42920001

DOI10.1016/j.rcpeng.2022.06.006

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.