Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of medications that have the potential to transform cardiovascular risk prevention. Given that people with serious mental illnesses (SMIs), including schizophrenia, bipolar disorder, and major depressive disorder, experience 10-to-20-year premature mortality driven by a high prevalence of cardiovascular risk factors, GLP-1s could have a high impact in this population.
In a research letter in JAMA Psychiatry, Dr. Beth McGinty, chief of the Division of Health Policy and Economics and co-founding director of the Cornell Health Policy Center, and colleagues used Inovalon Insights Real-World Data to examine GLP-1 prescriptions among adults with versus without SMI from 2018 to 2024. In this large national sample of adults with commercial insurance, Medicare, or Medicaid, more adults with versus without SMI received a GLP-1 prescription. However, GLP-1 receipt was lower among adults with schizophrenia, which may suggest the need to support equitable prescribing for this population. Overall, GLP-1 receipt increased among both groups between 2018 and 2024.
Current evidence suggests that GLP-1s can treat indicated conditions among people with SMI, including those using antipsychotic medications, without adverse psychiatric effects. Findings also indicate that GLP-1s should be considered part of comprehensive care that incorporates behavioral lifestyle changes and possibly other medications. The authors state that research should continue to assess GLP-1 continuity among people with SMI.
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