PSYREFLECT

Issue #76

September 24, 2026

#1Research

Two weight-friendlier antipsychotics, tested head to head, came out nearly even

Switched off olanzapine for weight gain, patients on cariprazine lost 0.82 kg more than those on aripiprazole over 12 weeks – a real difference, not a clear winner.

cariprazinearipiprazoleantipsychotic switchingmetabolic syndrome
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#2Research

Ketone levels, not weight loss, track symptom change on a ketogenic diet in psychosis

Weight loss did not track with symptom or metabolic improvement on the ketogenic diet – blood ketone level did, for both pre-diabetic markers and depression.

ketogenic dietpsychosisschizophreniabipolar disorder
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#3Tool

Two named fixes for antipsychotic metabolic syndrome sit outside the guideline

The guideline in force since January 2025 tells a psychiatrist how to test for metabolic syndrome; a 2024 literature review is what tells one how to treat it.

metabolic syndromeantipsychoticsaripiprazolemetformin
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#4Industry

FDA drops its suicide warning from GLP-1 obesity drugs

The trials that cleared GLP-1 drugs of a suicide signal excluded almost exactly the patients now being prescribed them for a psychiatric metabolic burden.

GLP-1suicide riskFDAdrug safety
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#5Industry

An eleven-year-old metabolic checklist for antipsychotics still misses most patients

The measurement that took one visit had the highest compliance on the Lester chart; the one that needed six had the lowest.

cardiometabolic monitoringantipsychoticsLester ToolNICE guidelines
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#6Resource

A private foundation funds the CME an entire field skipped

A private family foundation, not a professional society, built the only free, accredited course on the metabolic theory of mental illness.

metabolic psychiatryCMEbrain energymitochondrial dysfunction
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