GLP-1 Receptor Agonist Prescription Among Individuals with Schizophrenia

Sarosh Khan DO (1,2), Julia Browne PhD (1), Brittany Gouse MD (1,2), Amelia Blanton BS (1), Rayah Touma Sawaya MD (1,2), Faris Katkhuda MD (1,2), Hannah Brown MD (1,2)
1. Wellness and Recovery After Psychosis (WRAP) Research Program. Department of Psychiatry, Boston Medical Center
2. Boston University Chobanian and Avedisian School of Medicine

Background: Schizophrenia is associated with an up to 20-year reduction in life expectancy due to cardiometabolic disease1. Glucagon-like peptide 1 receptor agonists (GLP-1 RA) are increasingly being used for weight loss, and are shown to lower BMI and reduce risk of metabolic disorders among the general population2. GLP-1 RAs are safe and tolerable among individuals with schizophrenia3. Prescription patterns, clinical and sociodemographic factors associated with GLP-1 RA prescription among individuals with schizophrenia in clinical practice are not well understood.

Methods: We utilized Slicer Dicer within EPIC to conduct a retrospective chart review of individuals with ICD-10 codes (F.20, F.29 and F.25) for schizophrenia, schizoaffective disorder and unspecified psychosis, with concurrent prescription for a GLP-1 RA at Boston Medical Center, between August 2020 and August 2025.

Results: Between 2020 and 2025, the number of individuals with a primary psychotic disorder prescribed a GLP-1 RA increased by nearly 4-fold (from 127 to 513 individuals). 81.4% of individuals prescribed a GLP-1 RA were also taking an antipsychotic medication, with the most commonly co-prescribed antipsychotic medication being Aripiprazole (19.7%), Olanzapine (15.9%) and Risperidone (15.2%). Between January and August 2025, the demographic breakdown of individuals with a primary psychotic disorder and concurrent GLP-1 RA prescription was as follows: N = 513, 51% female, 59% Black; and breakdown by age: 5% younger than 27 years old, 46% between age 27 to 54; 48% between ages 54 and 82, and 1% older than 82 years. 37% of individuals received a diagnosis of Diabetes Mellitus Type II. 47% of individuals received a diagnosis of Class I, II or III Obesity.

Conclusions: Future work is needed to elucidate GLP 1 RA prescription patterns in schizophrenia in addition to metabolic outcomes among individuals with schizophrenia based on concurrent antipsychotic medication with GLP-1 RAs.