Great Expectations: Semaglutide as Antidiabetic Weight Management in a Psychiatric Hospital.

This report examines the use of glucagon-like peptide 1 (GLP-1) receptor agonists, specifically semaglutide, to mitigate metabolic side effects such as weight gain and poor glycemic control caused by psychotropic medications in patients with type 2 diabetes (T2D) in inpatient psychiatric settings. Two case studies demonstrate that weekly semaglutide injections improved hemoglobin A1c levels, stabilized weight, reduced insulin requirements, and enhanced other cardiometabolic biomarkers in patients receiving second-generation antipsychotics. While GLP-1 receptor agonists offer metabolic and cardiovascular benefits, their high cost, insurance barriers, and supply shortages pose challenges to widespread use, prompting the implementation of formulary restrictions to optimize access. The report suggests that integrating GLP-1 receptor agonists into psychiatric care may improve metabolic outcomes but calls for further research on long-term efficacy, adherence, and broader patient inclusion criteria.