{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T18:51:41Z","timestamp":1792349501642,"version":"4.4.0"},"reference-count":36,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec id=\"S2056472426120018_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with schizophrenia spectrum disorders (SSDs) experience high rates of obesity and metabolic dysfunction, contributing substantially to excess morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide and tirzepatide have demonstrated substantial efficacy for weight and glycaemic outcomes in the general population, but evidence in people with SSDs remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120018_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To synthesise all placebo-controlled, randomised controlled trials (RCTs) examining semaglutide and\/or tirzepatide in people with SSDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120018_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A preregistered systematic review and meta-analysis of RCTs examining the efficacy and safety of semaglutide and\/or tirzepatide in adults with SSDs was conducted. Outcomes and adverse events were pooled using random-effects meta-analysis. Certainty of evidence was assessed using the GRADE criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120018_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three trials (\n                      <jats:italic>n<\/jats:italic>\n                      = 258) met inclusion criteria, examining semaglutide dosages of 1.0\u20132.0 mg over 26\u201336 weeks. No trials examining tirzepatide were found. Semaglutide significantly reduced body weight (\u221211.32 kg; 95% CI \u221215.35 to \u22127.29), body mass index (\u22123.58 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; 95% CI \u22124.86 to \u22122.30), haemoglobin A1c (\u22120.37%; 95% CI \u22120.51 to \u22120.22) and fasting glucose (\u22120.54 mmol\/L; 95% CI \u22120.94 to \u22120.13). In adverse event analyses, semaglutide was associated with increased risks of abdominal pain (risk ratio 2.93; 95% CI 1.13\u20137.60), vomiting (risk ratio 2.57; 95% CI 1.39\u20134.77) and constipation (risk ratio 3.23; 95% CI 1.14\u20139.18). There was no evidence of increased risk of serious adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120018_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Semaglutide produces clinically meaningful improvements in weight and glycaemic outcomes in people with SSDs, with an adverse event profile consistent with known gastrointestinal effects of GLP-1 RAs in the general population. These findings support semaglutide as a promising adjunctive metabolic intervention in this population, although larger and longer trials, specifically those testing tirzepatide, are needed to better characterise heterogeneity of effects and long-term safety of these promising pharmacological treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2026.12001","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T09:37:20Z","timestamp":1779701840000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["The safety and efficacy of semaglutide in people with schizophrenia spectrum disorders: systematic review and meta-analysis of randomised controlled 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