Metformin for treatment of antipsychotic-induced weight gain: A randomized, placebo-controlled study
ABSTRACT To evaluate the efficacy of metformin for treatment of antipsychotic-induced weight gain.
Seventy-two patients with first-episode schizophrenia who gained more than 7% of their predrug weight were randomly assigned to receive 1000 mg/d of metformin or placebo in addition to their ongoing treatment for 12 weeks using a double-blind study design. The primary outcome was change in body weight. The secondary outcomes included changes in body mass index, fasting glucose and insulin, and insulin resistance index.
Of the 72 patients who were randomly assigned, 66 (91.6%) completed treatments. The body weight, body mass index, fasting insulin and insulin resistance index decreased significantly in the metformin group, but increased in the placebo group during the 12-week follow-up period. Significantly more patients in the metformin group lost their baseline weight by more than 7%, which was the cutoff for clinically meaningful weight loss. Metformin was tolerated well by majority patients.
Metformin was effective and safe in attenuating antipsychotic-induced weight gain and insulin resistance in first-episode schizophrenia patients. Patients displayed good adherence to metformin.
- SourceAvailable from: Ali Sahraian
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- "The patients had to have a relatively stable improvement with the total score of PANSS ≤ 60 (Wang et al., 2012). This trial was approved by the Ethics Committee of Shiraz University of Medical Sciences and it was conducted according to the Declaration of Helsinki and subsequent revisions. "
ABSTRACT: BACKGROUND: Many patients with schizophrenia suffer from metabolic symptoms and weight gain in which predispose them to obesity, diabetes, and cardiovascular problems. This trial examines the efficacy and safety of zonisamide on weight and body mass index in patients with schizophrenia being administered with atypical antipsychotics. METHOD: In this 10-week, double blind randomized placebo controlled clinical trial, forty one patients with schizophrenia diagnosed according to DSM-IV-TR criteria who were taking a stable dose of atypical antipsychotic are allocated into one of the two groups of zonisamide or placebo group. Weight, body mass index, waist circumference, and adverse effects were assessed. RESULTS: The two groups were not statistically different regarding baseline characteristics on age, gender, education, diagnosis, weight, body mass index, daily cigarette smoking, and the duration of illness. After 10weeks, the patients in the placebo group had significantly gained weight, while the patients in the zonisamide group lost weight (mean=1.9, SD=2.2 versus mean=-1.1kg, SD=1.4). The changes of body mass index in the two groups were significantly different. Body mass index decreased in the zonisamide group (mean=-0.3, SD=0.4) while it increased in the placebo group (mean=2.2, SD=6.9). There was a significance difference between the two groups regarding waist circumference at the end of trial (P<0.0001), too. The waist increased in the placebo group while it decreased in the zonisamide group (mean=1.1, SD=1.7 versus mean=-0.7, SD=1.2, respectively), as well. The frequencies of adverse effects were not significantly different between the two groups and zonisamide was tolerated well. CONCLUSION: Zonisamide as an adjuvant treatment is tolerated well and markedly affect on the weight loss of patients with schizophrenia being treated with atypical antipsychotics.Schizophrenia Research 04/2013; 147(1). DOI:10.1016/j.schres.2013.03.021 · 4.43 Impact Factor
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- "Randomized, double-blind, placebo-controlled pilot study published in JAMA concludes that a relatively low dosage of metformin reduces insulin resistance and related cardiovascular risk parameters in HIV-infected patients with lipodystrophy and a recent meta analysis has seconded the prime efficacy of metformin in this syndrome over other regimens  . A recent study has confirmed the metformin's safe role in antipsychotic induced weight gain reduction in schizophrenic patients . PCOS is notoriously famous endocrinopathy among fertility specialists and it affects around 5–10% women of child-bearing age . "
ABSTRACT: Metformin, a biguanide is well known treatment for type 2 diabetes mellitus that has diverse mechanism of actions. Various studies have elucidated the role of this drug in different pathologies. The well-known United Kingdom Prospective Diabetic Study (UKPDS) has observed its survival benefits in a large cohort of individuals. Data has been conclusive that metformin also has beneficial role in lipid disorders as it improves the markers of metabolic syndrome. Studies have also shown the beneficial roles in antipsychotic induced weight gain as well as HIV lipodystrophy syndrome. Evidence is accumulating that metformin also improves the fertility in females with Polycystic Ovarian Syndrome (PCOS). It also delays aging and is effective in aging related disorders and is equally effective in inflammation related disorders at least in different rodent studies. Metformin's major effect has been shown in various cancers ranging from solid to hematological malignancies. Researchers are working to reveal more benefits of this magic drug but it remains an unexplored territory for the medical community.European Journal of Internal Medicine 11/2012; 24(1). DOI:10.1016/j.ejim.2012.10.011 · 2.30 Impact Factor
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ABSTRACT: Research suggests that the prevalence of obesity in children with autism spectrum disorder (ASD) is at least as high as that seen in typically developing children. Many of the risk factors for children with ASD are likely the same as for typically developing children, especially within the context of today's obesogenic environment. The particular needs and challenges that this population faces, however, may render them more susceptible to the adverse effects of typical risk factors, and they may also be vulnerable to additional risk factors not shared by children in the general population, including psychopharmacological treatment, genetics, disordered sleep, atypical eating patterns, and challenges for engaging in sufficient physical activity. For individuals with ASD, obesity and its sequelae potentially represent a significant threat to independent living, self-care, quality of life, and overall health.Harvard Review of Psychiatry 01/2014; 22(2):93-103. DOI:10.1097/HRP.0000000000000031 · 2.49 Impact Factor