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People living with schizophrenia spectrum disorders (SSDs) frequently face severe metabolic challenges. Antipsychotic medications often lead to rapid weight gain and insulin resistance. Consequently, this population suffers from significantly higher morbidity rates compared to the general public. Semaglutide for schizophrenia is emerging as a critical intervention to combat these metabolic side effects.
A recent meta-analysis of three randomized controlled trials examined the impact of semaglutide dosages ranging from 1.0 to 2.0 mg. The results showed that semaglutide significantly reduced body weight by an average of 11.32 kg over 26 to 36 weeks. Additionally, participants experienced a decrease in body mass index (BMI) by 3.58 kg/m². Beyond weight, semaglutide improved glycemic markers, lowering haemoglobin A1c by 0.37% and fasting glucose by 0.54 mmol/L. These findings suggest that GLP-1 receptor agonists provide a robust metabolic lifeline for psychiatric patients.
While the efficacy is clear, clinicians must monitor for gastrointestinal side effects. The analysis revealed that semaglutide was associated with an increased risk of abdominal pain, vomiting, and constipation. Specifically, the risk of constipation was more than three times higher in the treatment group. However, there was no evidence of an increased risk of serious adverse events. Therefore, semaglutide remains a safe and promising adjunctive treatment for metabolic dysfunction in this vulnerable population.
Current evidence supports semaglutide as a viable tool for managing weight in SSD patients. However, the study highlights a lack of data for other agents like tirzepatide. Researchers emphasize the need for larger and longer trials to fully understand long-term safety. Future studies should also explore how these treatments affect different patient subgroups to minimize heterogeneity in clinical outcomes.
Studies show that semaglutide can lead to a weight reduction of over 11 kg in patients with schizophrenia spectrum disorders. This is particularly relevant for those taking second-generation antipsychotics that cause weight gain.
Current meta-analyses suggest no increased risk of serious adverse events. The primary side effects are gastrointestinal, such as nausea, vomiting, and constipation, which are usually mild to moderate.
Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or a professional relationship. Refer to the latest local and national guidelines for clinical practice.
References

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Semaglutide significantly reduces body weight and HbA1c in patients with schizophrenia spectrum disorders, according to a 2026 systematic review and meta-an...
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