Menon Trisha, Lee Serene, Gong Xuan Yi, Wong Sabrina, Le Gia Han, Kwan Angela T H, Teopiz Kayla M, Ho Roger, Cao Bing, Rhee Taeho Greg, Jing Zheng Yang, Valentino Kyle, Lin Kangguang, Vinberg Maj, Lo Heidi K Y, McIntyre Roger S
Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada.
Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
CNS Spectr. 2024 Nov 25:1-7. doi: 10.1017/S1092852924000531.
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.
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.
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.
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.
许多精神药物与相关体重增加高度相关。胰高血糖素样肽-1受体激动剂（GLP-1RAs）是已确立的抗肥胖和降糖药物。初步证据还表明，它们适用于减轻精神药物相关体重增加（PDWG）。本系统评价旨在综合随机对照试验（RCTs）中关于GLP-1RAs对经历PDWG者体重变化影响的现有证据。
检索在线数据库（即PubMed、OVID Medline、谷歌学术），以识别从开始到2024年1月1日的相关研究。由三名独立评审员根据纳入和排除标准，通过标题、摘要和全文对文章进行筛选。
我们确定了六项研究，参与者年龄≥18岁（n=374），符合纳入我们系统评价的条件。大多数研究报告了GLP-1RAs对人体测量学和/或代谢指标有显著且具有临床意义的影响。所有随机对照试验都重复了GLP-1RAs有适度或更大影响的发现；研究最多的药物是利拉鲁肽和艾塞那肽。文献不足，无法进行荟萃分析。
有证据表明，GLP-1RAs在减轻服用精神科药物者的体重增加方面有效。据推测，GLP-1RAs可能通过对与饥饿/饱腹感相关的代谢和认知过程产生直接影响，来调节服用精神科药物者的体重变化。未来的研究应旨在探索各种GLP-1RAs在治疗和预防精神科人群体重异常和代谢稳态方面的长期安全性、耐受性和疗效。
