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: Ganesan VenkatasubramanianIndian Journal of Psychiatry 04/2013; 55(2):207-8. DOI:10.4103/0019-5545.111475
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ABSTRACT: Diabetes mellitus and depressive disorders are both common chronic diseases that increase functional disability and social burden. Cognitive impairment is a potentially debilitating feature of depression. Previous evidence has revealed that the antidiabetic drug metformin could be suitable for diabetic patients with cognitive impairment. However, there is no direct evidence from clinical studies that metformin treatment improves cognitive function in diabetic patients suffering from depression. In this study 58 participants, diagnosed with depression and type 2 diabetes mellitus, were recruited and divided into two groups: one treated with metformin and one with placebo for 24 weeks. Cognitive function, depressive behavior and diabetes improvement were evaluated. Chronic treatment with metformin for 24 weeks improved cognitive performance assessed by the Wechsler Memory Scale-Revised (WMS-R) in depressed patients with type 2 diabetes mellitus. In addition, metformin significantly improved depressive performance and changed the glucose metabolism in depressed patients with diabetes. Depressive symptoms negatively correlated with the cognitive performance in metformin-treated participants. Furthermore, associations were also observed between the parameters of blood glucose metabolism and the depression phenotype. These findings suggested that chronic treatment with metformin produced antidepressant behavioral effects, and that improved cognitive function is involved in the therapeutic outcome of metformin. The current results also raised the possibility that supplementary administration of antidiabetic medications might enhance the recovery of depression, co-morbid with type 2 diabetes mellitus, through improvements in cognitive performance.This article is protected by copyright. All rights reserved.Clinical and Experimental Pharmacology and Physiology 05/2014; 41(9). DOI:10.1111/1440-1681.12265 · 2.41 Impact Factor
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ABSTRACT: OBJECTIVE The purpose of this study was to determine whether metformin promotes weight loss in overweight outpatients with chronic schizophrenia or schizoaffective disorder. METHOD In a double-blind study, 148 clinically stable, overweight (body mass index [BMI] ≥27) outpatients with chronic schizophrenia or schizoaffective disorder were randomly assigned to receive 16 weeks of metformin or placebo. Metformin was titrated up to 1,000 mg twice daily, as tolerated. All patients continued to receive their prestudy medications, and all received weekly diet and exercise counseling. The primary outcome measure was change in body weight from baseline to week 16. RESULTS Fifty-eight (77.3%) patients who received metformin and 58 (81.7%) who received placebo completed 16 weeks of treatment. Mean change in body weight was -3.0 kg (95% CI=-4.0 to -2.0) for the metformin group and -1.0 kg (95% CI=-2.0 to 0.0) for the placebo group, with a between-group difference of -2.0 kg (95% CI=-3.4 to -0.6). Metformin also demonstrated a significant between-group advantage for BMI (-0.7; 95% CI=-1.1 to -0.2), triglyceride level (-20.2 mg/dL; 95% CI=-39.2 to -1.3), and hemoglobin A1c level (-0.07%; 95% CI=-0.14 to -0.004). Metformin-associated side effects were mostly gastrointestinal and generally transient, and they rarely led to treatment discontinuation. CONCLUSIONS Metformin was modestly effective in reducing weight and other risk factors for cardiovascular disease in clinically stable, overweight outpatients with chronic schizophrenia or schizoaffective disorder over 16 weeks. A significant time-by-treatment interaction suggests that benefits of metformin may continue to accrue with longer treatment. Metformin may have an important role in diminishing the adverse consequences of obesity and metabolic impairments in patients with schizophrenia.American Journal of Psychiatry 07/2013; 170(9). DOI:10.1176/appi.ajp.2013.12010127 · 13.56 Impact Factor