GLP ‐1 Receptor Agonists Use in Patients With Prior Psychotropic Treatment: A Nationwide Cohort Study

Aims Psychotropic medications are frequently associated with weight gain and metabolic syndrome. While GLP‐1 receptor agonists (GLP‐1RAs) have generated interest for managing these adverse effects, their current uses in psychiatric populations have to be described. This study aims to describe the real‐world patterns of GLP‐1RA initiation and persistence among psychotropic users in France. Materials and Methods Using the French National Health Data System, we identified prevalent users of psychotropic medications who initiated GLP‐1RAs between 2017 and 2023. Patients were characterized by their indication for GLP‐1RA treatment (Type 2 diabetes mellitus [T2DM], obesity or neither) and the class of psychotropic medication dispensed. One‐year trajectories of monthly GLP‐1RA dispensings were analysed using group‐based trajectory modelling. Results In this nationwide cohort of 102 709 patients initiating GLP‐1RAs after psychotropic use, almost all patients were identified with T2DM (95%). Anxiolytics/hypnotics (> 66%), antidepressants (> 56%) and antipsychotics (> 15%) were the most frequently dispensed psychotropics. Less than 5% of patients lacked a clear indication for GLP‐1RA. The predominant trajectory was high persistence with GLP‐1RA treatment over 1 year (> 60%). Early disruption presented the lowest proportion of T2DM (80%) and the highest use of antiemetic drugs (8%). Conclusions In France, GLP‐1RA use among psychotropic users remained primarily in T2DM, regardless of psychotropic class. Off‐label use for psychotropic‐induced weight gain appeared very limited. High persistence rates were notable, given the challenges of treatment adherence in mental health populations. These findings suggested a predominantly persistent use of GLP‐1RAs within labelled indications in the psychiatric population.