Promising translatable pharmacological interventions for body weight management in individuals with severe mental illness - a narrative review.

Abstract

INTRODUCTION:

Psychotropic medications, especially antipsychotics, have been consistently shown to cause weight gain in individuals with severe mental illness (SMI), a population inherently challenged by poor physical health. Consequently, compared to the general population, this contributes to an increased cardiometabolic burden, including the risk of type 2 diabetes, dyslipidemia, and hypertension. Furthermore, comorbid obesity leads to treatment nonadherence, decreased quality of life, and increased risk of relapse, posing a challenge in the management of mental health. To address this, emerging agents investigated in the general population with potential to mitigate weight gain were explored to assess translatability to the SMI population.

AREAS COVERED:

A literature search was conducted including agents approved for the management of obesity in the general population, along with upcoming agents under investigation in phase III trials with weight loss properties.

EXPERT OPINION:

Metformin and topiramate along with lifestyle interventions are commonly prescribed for weight gain in individuals with SMI; however, their weight loss potential is modest at best. This review identified tirzepatide and cagrilintide-semaglutide among others as promising agents for adjunctive pharmacological management of weight gain.

• Authors: Riddhita De, Femin Prasad, Nicolette Stogios, Luisa Burin, Bjørn H Ebdrup, Filip K Knop, Margaret K Hahn, Sri Mahavir Agarwal
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) 2023 Sep-Dec Vol. 24 Issue 16 Pg. 1823-1832 ISSN: 1744-7666 [Electronic] England
• PMID: 37653675 (Publication Type: Journal Article, Review)

Chemical References

• Antipsychotic Agents

Topics

• Humans
• Diabetes Mellitus, Type 2 (drug therapy, complications)
• Quality of Life
• Mental Disorders (drug therapy, psychology)
• Obesity (drug therapy, epidemiology)
• Weight Gain
• Antipsychotic Agents (therapeutic use)
• Weight Loss