Course Summary

Expiration Date: 11/18/2028

Schizophrenia shortens life expectancy by 16–20 years, largely due to cardiovascular and metabolic disease. Clozapine, while the most effective treatment for refractory illness, carries the highest risk for weight gain, insulin resistance, and dyslipidemia, driven by receptor effects at histamine H₁, serotonin 5-HT₂C, and muscarinic M₃ sites. Lifestyle programs, metformin, and first-generation GLP-1 receptor agonists provide only modest benefit. The COaST trial, a phase 2 randomized study, evaluated semaglutide in clozapine-treated adults and found significant reductions in weight, BMI, fat mass, visceral adiposity, and HbA1c compared with placebo. Clozapine levels and psychiatric symptoms were unchanged, and adverse events were mainly gastrointestinal.

Course Format

Homestudy

Course Syllabus

  • Introduction
  • Metabolic Impact of Atypical Antipsychotics
  • Pathophysiology of Antipsychotic-Induced Weight Gain
  • Pathophysiology of Antipsychotic-Induced Weight Gain
  • JOURNAL CLUB: Addressing Clozapine’s Metabolic Burden with Semaglutide
    • Introduction
    • Methods
    • Results
    • Safety
    • Discussion
  • Summary

Authors

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.

Elisabeth Gordon, BScPharm, RPh

Elisabeth Gordon earned her BSc(Pharm) from the University of British Columbia in 2004. After graduation, she worked in community retail pharmacies on Vancouver Island, before returning to her rural hometown of Salmon Arm. In 2016 and 2017, Elisabeth trained with Pallium Canada and Victoria Hospice to enhance her knowledge of end-of-life-care and palliative services. She is a volunteer medical supervisor for T1DOutreach, a peer support platform for adults living with type 1 diabetes, and a member of a Canadian peer support group for adults living with Birdshot Uveitis. Elisabeth enjoys working in a small, fast-paced rural pharmacy where she brings compassion and empathy to her everyday practice.