Semaglutide Shows Promise in Improving Metabolic and Physical Health in Patients with Schizophrenia on Antipsychotics

A collaborative study conducted by Danish researchers has revealed that weekly administration of semaglutide over a period of 30 weeks can significantly improve both metabolic and physical health outcomes in adults with schizophrenia who are undergoing treatment with second-generation antipsychotics. The study, published in JAMA Psychiatry, focused on patients with prediabetes and obesity—common comorbidities linked to antipsychotic medication use.

The randomized, double-blind clinical trial involved 154 participants aged 18 to 60 years, with 141 completing the full 30-week intervention. Participants received either semaglutide or a placebo once a week, with medication titrated to a maximum dose of 1.0 mg. Most assessments and visits took place in participants' homes, ensuring convenience and real-world applicability.

Results demonstrated a notable reduction in blood sugar levels, with HbA1c decreasing by 0.46% compared to the placebo group. Remarkably, 81% of those treated with semaglutide achieved HbA1c levels below 5.7%, indicating improved glycemic control. Additionally, participants experienced significant weight loss of approximately 9.2 kilograms, alongside improvements in lipid profiles—HDL cholesterol increased by 10.81 mg/dL and triglycerides decreased by 29.20 mg/dL.

Physical quality of life improved, with scores increasing by 3.75 points, although mental health outcomes and schizophrenia symptom severity, measured via PANSS-6, showed no substantial change. Gastrointestinal symptoms, commonly associated with GLP-1 receptor agonists, were more frequent early in treatment but tended to lessen over time, and serious adverse effects did not differ between the treatment and placebo groups.

The study's authors concluded that weekly semaglutide at the dose of 1.0 mg is a safe and effective option to improve glycemic control, promote weight loss, and enhance physical well-being in patients with schizophrenia receiving antipsychotics. These findings point toward the potential of semaglutide as a candidate therapy capable of addressing the metabolic side effects commonly seen with second-generation antipsychotics, thereby offering a dual benefit of improving physical health without compromising psychiatric stability.

This research underscores the importance of exploring new pharmacological strategies to mitigate cardiometabolic risks in psychiatric populations, potentially reducing the burden of premature morbidity and mortality associated with schizophrenia treatment.