Glucagon-like peptide-1 (GLP-1) agonist

  • SE-weight loss
  • May reduce alcohol/nicotine use

Dosing

Start: 0.25 mg inj weekly. Target: 2.4 mg inj weekly, after dose increases every 4 weeks.

Management

Only use if BMI > 30 or > 27 with an obesity related health condition (hypertension, dyslipidemia, diabetes).

May reduce addictions (alcohol, nicotine). May improve mood and cognition.

TOLERABILITY: Nausea, vomiting, diarrhea, and constipationAdvise patient to eat more protein (to prevent muscle wasting) and avoid over-eating (to prevent reflux).

RISKS: Gastric slowing, pancreatitis, gall bladder problems, thyroid cancer.

EMR Text

Obesity

Semaglutide use based on FDA approval in obesity, including controlled trials of GLP-1 agonists in psychiatric populations with obesity.

Semaglutide’s risks, including slowed gastric motility, medullary thyroid cancer, and hypoglycemia, reviewed with patient.

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