Anti-obesity drugs and mental health, emerging therapeutic pathways from the Sinpf Congress

Metabolism and psychiatry at the center of new research
Anti-obesity drugs acting as GLP-1 receptor agonists are drawing growing attention as potential adjuncts in the treatment of psychiatric disorders, particularly for managing weight gain associated with psychotropic medications and possibly influencing mood disorders. These perspectives were discussed at the XXVII National Congress of the Italian Society of Neuropsychopharmacology (Sinpf), held in Milan and focused on the interaction between metabolism and mental health.

GLP-1 agonists beyond diabetes and obesity
Speakers highlighted that GLP-1 receptor agonists such as semaglutide, liraglutide and tirzepatide, already established in the management of diabetes and obesity, are showing early signals of relevance in neuropsychiatric settings. One major area of interest concerns the control of antipsychotic-induced weight gain, a frequent adverse effect that negatively affects treatment adherence and increases metabolic and cardiovascular risk.

Clinical data on weight control in psychiatric patients
Among the evidence discussed was a study published in JAMA Psychiatry, conducted at the Charité University Hospital in Berlin. The research evaluated the use of semaglutide and liraglutide in patients receiving antipsychotic therapy. Over 24 weeks, semaglutide was associated with an average 8% reduction in body weight, while liraglutide led to a reduction of around 5%. In contrast, patients treated with metformin, currently considered standard care, showed largely stable body weight. According to Sinpf experts, limiting psychotropic-induced hyperphagia could lower the long-term risk of diabetes and cardiovascular disease in psychiatric populations.

Genetic links between GLP-1 activity and mood disorders
A second research pathway extends the potential role of GLP-1 beyond weight management. Findings from a study published in BMC Psychiatry, conducted by Seoul National University Biomedical Informatics on more than 360,000 individuals, used Mendelian randomization to explore genetic associations. The analysis showed that higher genetically determined GLP-1 receptor activity was linked to a lower risk of major depressive disorder and bipolar disorder, suggesting a possible direct involvement of the GLP-1 system in affective regulation circuits.

Toward precision psychiatry
According to Sinpf, these converging lines of evidence support the concept of precision psychiatry, in which metabolic drugs could complement traditional psychopharmacological treatments. Integrating metabolic and psychiatric approaches may improve tolerability, adherence and overall patient management, stabilizing both metabolic profiles and psychiatric symptoms.

Caution and future directions
Experts emphasized that evidence regarding mood disorders remains preliminary and does not yet justify new therapeutic indications. Nevertheless, the data open the way to further clinical trials and to a broader interdisciplinary dialogue involving psychiatry, endocrinology and internal medicine.

Prof. Foad Aodi