Students Research in Progress
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction: Metabolic comorbidities associated with antipsychotics are increasing following an increase in the diagnosis and treatment of mental health disorders. Consequences of antipsychotic treatment include increased risk of metabolic syndrome and cardiovascular events. Current recommendations to mitigate antipsychotic-associated weight gain includes metformin and topiramate. Incretin therapies (Glucagon-like protein-1 receptor agonists, GLP-1RAs) or dual GLP-1 and gastric inhibitory peptide (GIP) receptor agonists are an emerging alternative. However, the safety and efficacy of incretin therapies for managing metabolic disease associated with antipsychotics is unclear.
Research Question or Hypothesis: In comparison to metformin, how do incretin therapies affect rates of psychiatric outcomes for patients taking antipsychotics?
Study Design: Retrospective Cohort Study
Methods: Cohorts were assembled within the TriNetX Research Network, a federated database collating deidentified patient data from electronic health records. Adult patients included were diagnosed with bipolar disorder, personality disorders, schizophrenia, or any non-mood psychotic disorders with a prescribed antipsychotic and either incretin therapy (Cohort GLP) or metformin (Cohort MET). Cohorts were balanced using 1:1 propensity score matching. Patients were followed for up to five years post-index date.
Results: Each cohort consisted of 3,574 patients. Average age was 51 years with a body mass index of 37kg/m2. Olanzapine was the most commonly prescribed antipsychotic. Patients in Cohort GLP had a lower risk for suicidal ideation RR 0.54 (95% CI 0.474,0.615; p <0.0001), suicide attempts RR 0.726 (95% CI 0.568, 0.928; p= 0.010), and self-harm RR 0.589 (95% CI 0.483,0.720; p <0.0001) compared to Cohort MET. Additionally, patients in Cohort GLP had lower risk for mortality RR 0.496 (95% CI 0.407, 0.606; p <0.001), drug overdose RR 0.494 (95% CI 0.346,0.707; p <0.0001), and substance use disorders RR 0.66 (95% CI 0.619, 0.705; p <0.0001) compared to Cohort MET.
Conclusion: In comparison to metformin, incretin therapies reduced risk for several psychiatric outcomes for patients receiving antipsychotic treatment.
Presenting Author
Hailey Kalamaras B.S.UNIVERSITY OF SOUTH FLORIDA
Authors
Scott Coon PharmD, BCACP
University of South Florida, Taneja College of Pharmacy
Amre Elmaoued PharmD, PhC, BCPP
University of New Mexico hospital
Matthew Perkel B.S.
UNIVERSITY OF SOUTH FLORIDA
Raechel White PharmD, PhC, BCACP
University of South Florida