Glucagon-Like Peptide Analogs Are Superior for Diabetes and Weight Control in Patients on Antipsychotic Medications

医学 减肥 内科学 抗抑郁药 糖尿病 抗精神病药 不利影响 内分泌学 肥胖 精神分裂症(面向对象编程) 精神科 海马体
作者
Lauren Perlis,J. Steven Lamberti,Susanne U. Miedlich
出处
期刊:The primary care companion for CNS disorders [Physicians Postgraduate Press, Inc.]
卷期号:22 (1) 被引量:4
标识
DOI:10.4088/pcc.19m02504
摘要

Glucagon-like peptide (GLP-1) analogs promote diabetes control and weight loss. Most GLP-1 analogs also lower adverse cardiovascular outcomes, making them ideal agents for patients with severe mental illness. The objective of this study was to analyze diabetic patients taking antipsychotic medications, comparing those on GLP-1 analogs with those on other diabetes treatments.A total of 46 patients referred to outpatient diabetes clinics between July 2010 and April 2017 who were prescribed antipsychotic medications during the entire study period were included in this retrospective analysis. Eleven (24%) patients were started on a GLP-1 analog (cases), and 35 (76%) were treated with alternative antidiabetic agents (controls).Cases and controls did not differ in age, sex, height, weight, or medical therapies at the time of referral. Within 1 year, a reduction in mean ± SE glycosylated hemoglobin (HbA1c) levels was noted for both groups (cases: -1.26% ± 0.17%, controls: -1.47% ± 0.45%). However, while patients on GLP-1 analogs lost 7.07 ± 2.62 kg, control patients gained 1.93 ± 1.14 kg (P < .05). Blunted HbA1c reductions were also noted in patients who took antipsychotic medication in addition to antidepressant medication (on antidepressant medication [n = 22]: -0.77% ± 0.29%, off antidepressant medication [n = 9]: -2.97% ± 0.6%, P < .001). This observation did not apply to patients treated with GLP-1 analogs, as they had larger HbA1c reductions than patients on alternative regimens (controls [n = 15]: -0.46% ± 0.4%, cases [n = 7]: -1.43% ± 0.15%, P < .05).GLP-1 analogs promote both diabetes and weight control in diabetic patients on antipsychotic medications with or without antidepressant medications.

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