Antidiabetic GLP-1 Analogs May Benefit Schizophrenia Patients With Antipsychotic-Induced Weight Gain

Scientists from Denmark suggested that GLP-1 analogs used in the treatment of type 2 diabetes may also have potential significant and sustained weight loss effects in schizophrenia patients with antipsychotic-induced weight gain.

Schizophrenia, a chronic, severe and disabling brain disorder affecting approximately 0.5 percent of people globally, is treated these days with second generation anti-psychotic medication such as olanzapine, risperidone, quetiapine and other such antipsychotics. However, one of the major side effects of these medications is weight gain and changes in the patient’s metabolism, thereby increasing the risk for diabetes and cardiovascular disease. There is evidence that such patients may lose 25 or more years of life expectancy and may even die of obesity related cardiovascular disease. Incidentally, current interventions against drug induced weight gain do not facilitate lasting or significant weight loss in schizophrenia patients.

In the search for more successful interventions, Bjorn Ebdrup and his colleagues from the University of Copenhagen, Denmark, in their debate article published in the BMC journal, have discussed the potential effects of using GLP-1 analogs to treat schizophrenia patients with antipsychotic-induced weight gain.

GLP-1 (glucagon-like peptide-1) is a gut hormone and currently GLP-1 analogs are used in the treatment of diabetes. These analogs work by mimicking the important functions of GLP-1 in the body, such as causing the pancreas to secrete insulin when glucose concentrations rise as well as working in the brain to promote appetite suppression, which ultimately leads to sustained weight loss.

Although six different GLP-1 analogs are being tested, only two of them – exenatide and liraglutide – have been approved by the U.S. Food and the Drug Administration and European Medicines Agency.

A clinical study is already investigating whether exenatide (a GLP-1 analog) can induce weight loss in overweight patients treated with olanzapine. Exenatide has already shown evidence of having a role in neuroprotection, learning and preventing memory impairment in animal models.

According to the researchers, the potential benefits of GLP-1 analog treatment can be

• Significant and lasting weight loss can be obtained in both diabetic and non-diabetic overweight patients.

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• An improved glycemic control can be obtained.

• Studies have shown that there might be a genetic link between schizophrenia and overweight /obesity. By exploring the cerebral effects of GLP-1 analogs in overweight schizophrenia patients and non-schizophrenia people, the link can be confirmed.

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Thus, the researchers opine, that ‘If the progressive brain loss and cognitive decline associated with schizophrenia and overweight/obesity can indeed be ameliorated by GLP-1 treatment, this will have major implications for future treatment of schizophrenia, but also for the treatment of obesity’.

They concluded that ‘adjunctive treatment with a GLP-1 analog holds promise as a novel method to treat metabolic and cerebral deficiencies in schizophrenia patients with antipsychotic-induced weight gain’.

Source: Ebdrup BH, Knop FK, Ishoy PL, Rostrup E, Fagerlund B, Lublin H, Glenthoj B. Glucagon-like peptide-1 analogues against antipsychotic-induced weight gain: potential physiological benefits. BMC Med. 2012 Aug 15;10(1):92


Source-Medindia