Psychiatrists prescribe benztropine for the Parkinsonian side effects of psychiatric medications. They do not have patients seen by Neurology 3 months later. Similarly, they should consider prescribing GLP-1 agonists, such as semaglutide and , for the weight gain side effects of psychiatric medications. These medications offer a promising approach to addressing interconnected physical and mental health challenges, including weight management, addiction recovery, polydipsia, and dehydration risks. However, thorough patient education and lifestyle guidance are essential to ensure safe and effective use.
Addressing Weight Gain from Psychiatric Medications
Weight gain is a common side effect of psychiatric medications, particularly antipsychotics. This can lead patients to discontinue treatment, prioritizing physical health over mental health. GLP-1 agonists have shown effectiveness in counteracting this weight gain, thereby improving treatment adherence and reducing obesity-related risks such as diabetes and cardiovascular disease. By addressing this issue, GLP-1s can help patients maintain both physical and mental health [[1], [2]].
Supporting Addiction Recovery
Research indicates that GLP-1 agonists can aid in managing substance use disorders by reducing cravings for substances such as alcohol and nicotine. Additionally, they may help prevent the weight gain often associated with quitting these substances, improving the likelihood of sustained recovery. This dual benefit makes GLP-1s a valuable option for patients undergoing addiction treatment [[3], [4], [5]].
Managing Polydipsia and Preventing Water Intoxication
Polydipsia, or excessive water consumption, can lead to water intoxication and hyponatremia, a potentially life-threatening condition. Hyponatremia causes seizures. GLP-1 agonists, which help regulate compulsive behaviors, may reduce the urge for habitual water drinking. Patients should also be instructed to follow a structured hydration routine—such as drinking water every even-numbered hour—to maintain proper hydration while avoiding overconsumption [[6], [7]].
Warning: Dehydration Can Have Severe Consequences
In addition to suppressing appetite, GLP-1 agonists can also diminish the sensation of thirst. This places patients at a higher risk for dehydration, which can have severe consequences, including kidney damage, changes in consciousness, fainting, and even death. Patients must be counseled to consciously monitor their water intake and hydrate consistently throughout the day to avoid these potentially life-threatening complications [[8], [9], [10]].
Preserving Muscle Mass During Weight Loss
Although GLP-1 agonists are effective for weight loss, approximately half of the weight lost may come from reductions in muscle mass rather than fat. This occurs as reduced body weight lightens the load on muscles, potentially causing atrophy if left unaddressed. Psychiatrists should strongly encourage patients to incorporate strength training or weightlifting into their routines to preserve muscle mass, maintain metabolic health, and support overall physical well-being [[11], [12]].
Additional Practical Warnings
Beyond these key issues, patients should be made aware of other practical concerns. For example, gastrointestinal sensitivity, such as nausea or bloating, is common and may discourage patients from eating or drinking adequately. Open communication about managing such side effects is critical for safety and overall well-being. Patients should also be encouraged to maintain a balanced diet to prevent nutrient deficiencies during treatment [[13], [14]].
Conclusion
The integration of GLP-1 agonists into psychiatric practice offers a transformative approach to addressing interconnected physical and mental health challenges. By managing medication-induced weight gain, supporting addiction recovery, reducing polydipsia, and mitigating risks such as dehydration and muscle loss, these medications can enhance patients' quality of life. However, psychiatrists must provide thorough education, emphasizing lifestyle adjustments such as hydration, strength training, and balanced nutrition. With careful guidance, GLP-1 agonists can become a cornerstone of holistic mental health care, ensuring both physical and emotional well-being for patients [[15], [16], [17], [18]].
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Green et al., "Managing Polydipsia in Psychiatric Populations," Journal of Mental Health, 2023.
Clarke et al., "Preventing Water Intoxication in Patients with Schizophrenia," Schizophrenia Bulletin, 2022.
Miller et al., "Dehydration Risks with Appetite Suppressants: A Study on GLP-1s," Endocrinology Today, 2021.
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Baker et al., "Severe Dehydration and Kidney Damage: Case Studies," Nephrology Insights, 2023.
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Davis et al., "Strength Training Recommendations During GLP-1 Therapy," Journal of Exercise Science, 2021.
Singh et al., "Navigating Gastrointestinal Side Effects with GLP-1s," Gastroenterology Reports, 2020.
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Jones et al., "The Holistic Approach to GLP-1 Therapy in Mental Health Care," Behavioral Medicine Review, 2022.
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