A double-blind, placebo-controlled trial of exenatide for the treatment of olanzapine-related weight gain in obese and overweight adults

J Affect Disord. 2025 Aug 1:382:116-122. doi: 10.1016/j.jad.2025.04.046. Epub 2025 Apr 7.

Abstract

Objective: To assess the safety and efficacy of exenatide in overweight or obese patients treated with olanzapine.

Methods: Adults with stable major mood or psychotic disorders were randomized to double-blind exenatide or placebo for 16 weeks. Weight and body mass index (BMI) were monitored throughout the study. A secondary objective was to evaluate the tolerability of exenatide and its effects on mood and psychotic symptoms.

Results: A significant difference in weight change was detected between the treatment groups. Participants in the exenatide group experienced on average a minor weight loss, while participants in the placebo group on average experienced weight gain (-0.5 kg [-0.6 %] vs. +2.6 kg [+2.8 %], both p < .01). The most common side effects in the exenatide group were gastrointestinal symptoms and headaches. There were no clinically meaningful differences between the groups in changes to mood or psychotic symptoms.

Conclusions: Exenatide is effective and well-tolerated for attenuating olanzapine-associated weight gain.

Clinical trial registration information: Exenatide for the Treatment of Weight Gain Associated with Olanzapine in Obese Adults. NCT00845507.

Keywords: Bipolar disorder; Depression; Exenatide; Olanzapine; Psychosis; Weight gain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antipsychotic Agents* / adverse effects
  • Antipsychotic Agents* / therapeutic use
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use
  • Body Mass Index
  • Double-Blind Method
  • Exenatide* / therapeutic use
  • Female
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Obesity* / chemically induced
  • Obesity* / drug therapy
  • Obesity* / psychology
  • Olanzapine* / adverse effects
  • Overweight / drug therapy
  • Peptides / adverse effects
  • Peptides / therapeutic use
  • Psychotic Disorders / drug therapy
  • Treatment Outcome
  • Venoms / adverse effects
  • Venoms / therapeutic use
  • Weight Gain / drug effects

Substances

  • Antipsychotic Agents
  • Benzodiazepines
  • Exenatide
  • Hypoglycemic Agents
  • Olanzapine
  • Peptides
  • Venoms

Associated data

  • ClinicalTrials.gov/NCT00845507