To the Editor Treatment with certain antipsychotic drugs (APDs) causes weight gain, leading to metabolic syndrome and increasing cardiovascular-associated mortality. Although several pharmacologic agents and some behavioral interventions attenuate APD-elicited weight gain, the effects are modest and rarely reduce body weight to baseline levels. In JAMA Psychiatry, Larsen et al¹ report that the antidiabetic agent liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, reduces body weight, improves glucose tolerance, and decreases systolic blood pressure in patients with schizophrenia receiving clozapine or olanzapine, 2 APDs with high weight-gain liability. The magnitude of weight loss seen in response to liraglutide in APD-treated patients with schizophrenia was consistent with previous studies of liraglutide in patients with type 2 diabetes and in patients without diabetes and with obesity, despite administration of a relatively low dose (1.8 mg) of liraglutide. Liraglutide-elicited weight loss was somewhat greater than that reported in studies of metformin, a biguanide antidiabetic agent used to attenuate APD-elicited weight gain. Liraglutide is potentially an important addition to the therapeutic armamentarium for APD-elicited weight gain and associated metabolic and cardiovascular changes.

致某些抗精神病药物（APDs）的治疗会导致体重增加，导致代谢综合征并增加与心血管相关的死亡率。尽管几种药物和某些行为干预措施可减轻APD引起的体重增加，但这种作用是适度的，很少将体重降低至基线水平。在《美国医学会杂志》（JAMA Psychiatry）中，拉尔森（Larsen）等人¹报告指出，抗精神病药利拉鲁肽是一种胰高血糖素样肽1（GLP-1）受体激动剂，可减轻患有氯氮平或奥氮平的精神分裂症患者的体重，提高其葡萄糖耐量，并降低收缩压，这2种高体重的APD承担责任。在APD治疗的精神分裂症患者中，对利拉鲁肽的体重减轻幅度与先前对利拉鲁肽在2型糖尿病患者，无糖尿病和肥胖患者中的研究一致，尽管给予的剂量相对较低（1.8 mg）利拉鲁肽。利拉鲁肽引起的体重减轻比二甲双胍研究中报道的要大，二甲双胍是一种双胍类抗糖尿病药，用于减弱APD引起的体重增加。