Incretin Therapies: A New Tool to Combat Metabolic Consequences of Antipsychotic Use

Context: Antipsychotic medications are associated with significant metabolic risks including weight gain, lipid abnormalities, and glucose intolerance. Incretin therapies could have massive potential to benefit patients affected by antipsychotic-induced weight gain. However, patients with psychiatric disorders were often excluded from clinical trials, leaving safety and efficacy in this population largely unexplored.

Evidence Acquisition: A narrative review was conducted to evaluate the data surrounding use of incretin therapies to mitigate metabolic consequences of antipsychotics and to review general safety and efficacy data relevant to prescribing of these agents to be distilled for the psychiatric provider. Package inserts, relevant clinical guidelines, and cardiometabolic outcomes trials were reviewed in developing the prescribing guide.

Results: Limited data suggest that incretin therapies may be effectively utilized in patients with psychiatric conditions. A prescribing guide and algorithm were developed and include information on selecting an agent based on comorbidities, dosing and prescribing, contraindications, and clinical pearls that may be of use to providers who wish to utilize incretin therapies in patients with psychiatric comorbidities.

Conclusion: Incretin therapies are highly effective medications for diabetes and weight management in the general population. While additional monitoring may be warranted in patients with psychiatric conditions, these agents are potentially effective and safe for use in treating obesity or overweight and diabetes in this population.

Prim Care Companion CNS Disord 2025;27(5):25nr03924.

Author affiliations are listed at the end of this article.