GLP-1 Prescription Rates Higher for Adults With Serious
A study of U.S. Insurance claims shows adults with serious mental illness received GLP-1 drug prescriptions at higher rates than those without SMI from
Adults with serious mental illness received GLP-1 agonist prescriptions at a higher rate than those without such conditions between 2018 and 2024. The finding comes from an analysis of U.S.
Prescription rates rose sharply for all adults with conditions like diabetes or obesity that indicate GLP-1 use. However, the increase was more pronounced for patients with serious mental illness, which includes schizophrenia, bipolar disorder, and major depressive disorder. Emma McGinty, PhD, the study's lead author, told MedPage Today the results were somewhat surprising given that this population often receives less guideline-concordant cardiovascular care.
Prescription Trends Over Time
The analysis tracked prescription rates among adults who had an underlying condition warranting GLP-1 treatment. For those with serious mental illness, the rate climbed from 2.3% in 2018 to 13.7% in 2024. For adults without serious mental illness, it rose from 1.8% to 11.1% over the same period.
One notable exception emerged for people with diabetes. Among this group, individuals with schizophrenia had lower prescription rates than those without any serious mental illness.
| Group | 2018 Rate | 2024 Rate |
|---|---|---|
| Adults with SMI | 2.3% | 13.7% |
| Adults without SMI | 1.8% | 11.1% |
Addressing Cardiovascular Risk
People with serious mental illnesses face a significantly higher burden of cardiovascular risk factors. They experience 10 to 20 years of premature mortality as a result. The researchers highlighted that GLP-1 receptor agonists are transforming cardiovascular risk prevention and could have a high impact in this population.
McGinty and her colleagues noted that existing evidence suggests GLP-1s effectively treat indicated conditions in people with serious mental illness, including those using antipsychotic medications, without adverse psychiatric effects. They argue these drugs should be part of comprehensive care that includes behavioral lifestyle changes and possibly other medications.
Study Details and Limitations
The research used data from Inovalon Insights Real-World Data, which includes deidentified claims for commercial, Medicare Advantage, and Medicaid Managed Care beneficiaries.
The breakdown of diagnoses and the prevalence of GLP-1-indicating conditions were significantly higher in this group compared to those without serious mental illness.
| Condition | Prevalence in Adults with SMI | Prevalence in Adults without SMI |
|---|---|---|
| Diabetes | 22.4% | 11.5% |
| Obesity | 42.9% | 21.8% |
| Sleep Apnea | 17% | 6.3% |
| Overweight + Chronic Condition | 16.9% | 8.7% |
The authors acknowledged limitations. The data were not nationally representative and did not capture medication use or prescriptions paid for out of pocket. They concluded that further research should assess how continuously people with serious mental illness stay on GLP-1 therapies.
The findings follow years of regulatory scrutiny over the psychiatric safety profile of GLP-1 drugs. Early adverse reports prompted a preliminary FDA review into suicidal ideation risks in early 2024. By January 2026, extensive safety evaluations led the agency to request that manufacturers remove warning language about suicidal behavior and ideation from drug labels entirely. McGinty said the study supports the idea that clinicians view these medications as safe and effective for people with serious mental illness, with the possible exception of those with schizophrenia.
