Cited by 98Schizophrenia research and treatmentPharmacology and Obesity TreatmentDiabetes Treatment and Management

Treatment of clozapine‐associated obesity and diabetes with exenatide in adults with schizophrenia: A randomized controlled trial ( CODEX )

Siskind, Dan J, Russell, Anthony W., Gamble, Clare, Winckel, Karl, Mayfield, Karla, Hollingworth, Sam, Hickman, Ingrid, Siskind, Victor +1 more·2018·Diabetes, Obesity and Metabolism

Abstract

Clozapine causes obesity and type 2 diabetes (T2DM). Glucagon‐like peptide‐1 (GLP‐1) receptor agonists (e.g. exenatide) can counter clozapine‐associated GLP‐1 dysregulation in animals, and may be beneficial in people on clozapine. This randomized, controlled, open‐label, pilot trial evaluated weekly exenatide for weight loss among clozapine‐treated obese adults with schizophrenia, with or without T2DM. A total of 28 outpatients were randomized to once‐weekly extended‐release subcutaneous exenatide or usual care for 24 weeks. The primary outcome was proportion of participants with >5% weight loss. All 28 participants completed the study; 3/14 in the exenatide group and 2/14 in the usual care group had T2DM. Six people on exenatide achieved >5% weight loss vs one receiving usual care ( P = .029). Compared with usual care, participants on exenatide had greater mean weight loss (−5.29 vs −1.12 kg; P = .015) and body mass index reduction (−1.78 vs −0.39 kg/m 2 ; P = .019), and reduced fasting glucose (−0.34 vs 0.39 mmol/L; P = .036) and glycated haemoglobin levels (−0.21% vs 0.03%; P = .004). There were no significant differences in other metabolic syndrome components. Exenatide may be a promising therapeutic agent for glycaemic control and weight loss in clozapine‐treated people with obesity, and could assist in reducing clozapine‐associated cardio‐metabolic morbidity and mortality.

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Crossref · 10.1111/dom.13167

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Authors
Siskind, D. J., Russell, A. W., Gamble, C., Winckel, K., Mayfield, K., Hollingworth, S., Hickman, I., Siskind, V., & Kisely, S.
Affiliations
  • The University of Queensland (AU)
  • Queensland Centre for Mental Health Research (AU)
  • Logan Hospital (AU)
  • School of Pharmacy University of Queensland Brisbane Australia
  • Princess Alexandra Hospital (AU)
  • Queensland University of Technology (AU)
Corresponding author
Siskind, Dan J
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2017-12-19
Volume
20
Issue
4
Pages
1050-1055
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
OpenAlex
W2772389138
Cited by
98
References
16
Citations by year
2026: 19 · 2025: 16 · 2024: 14 · 2023: 14 · 2022: 10 · 2021: 8 · 2020: 5 · 2019: 5 · 2018: 6 · 2016: 1
FWCI
3.60
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Obesity and Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Griffith Research Online (submittedVersion)
Funders
  • Rebecca L. Cooper Medical Research Foundation
  • National Health and Medical Research Council (ECF APP1111136)
  • PA Research Foundation
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
clozapine, exenatide, schizophrenia, obesity, type 2 diabetes, GLP-1 receptor agonists, weight loss, HbA1c, fasting blood glucose, metabolic syndrome
MeSH terms
Exenatide, Adolescent, Adult, Blood Glucose, Clozapine, Diabetes Mellitus, Type 2, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Obesity, Pilot Projects, Schizophrenia, Weight Loss, Young Adult

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