Metformin for Weight Loss in Pediatric Patients Taking Psychotropic Drugs

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
American Journal of Psychiatry (Impact Factor: 12.3). 05/2002; 159(4):655-7. DOI: 10.1176/appi.ajp.159.4.655
Source: PubMed


Metformin was assessed as a treatment for weight gain in children taking olanzapine, risperidone, quetiapine, or valproate.
The subjects were 19 patients aged 10-18 years; 15 were white and four were black, and there were 12 boys and seven girls. In a 12-week open-label study, each patient received metformin, 500 mg t.i.d. Changes in weight and body mass index were evaluated by using repeated measures analysis of variance.
Of the 19 patients, 15 lost weight, three gained 1.6 kg or less, and one had no change. The mean changes in weight and body mass index at 12 weeks were highly significant.
Metformin merits further study as a treatment for weight gain in patients taking psychotropic medications.

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    • "Metformin was shown to have a significant impact on reducing BW, BMI, and waist circumference compared with placebo. Morrison et al. (2002) performed an open-label study in 19 patients with a mean age of 14 years who had gained more than 10% of their pretreatment weight after commencing treatment with olanzapine, risperidone, quetiapine, or valproate. Metformin was shown to have a significant impact on reducing BW and BMI compared with placebo. "
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    ABSTRACT: There is uncertainty with regard to the appropriate use of metformin for the prevention and management of second-generation antipsychotic-induced weight gain and metabolic abnormalities. We aim to systematically review the primary literature and to provide recommendations with regard to the use of metformin in psychiatric populations prescribed second-generation antipsychotics. The authors undertook a literature search of Medline, EMBASE, and PsycINFO using the search terms; antipsychotic OR atypical antipsychotic AND weight AND metformin. Narrative review was undertaken without additional statistical analysis. The search provided 198 results from which 10 original research papers were identified: six randomized controlled trials and one open-label study for adults and two randomized controlled trials and one open-label study for children and adolescents. Four meta-analyses were also identified. We concluded that if weight gain occurs after second-generation antipsychotic initiation, despite lifestyle intervention, metformin should be considered. Further studies with adequate statistical power are required to determine the efficacy of metformin in those with chronic psychotic illness.
    Full-text · Article · Mar 2012 · International clinical psychopharmacology
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    • "Metformin holds promise as a treatment for weight gain in pediatric patients taking psychotropic medications. In a 12-week open label study [107] conducted on 19 patients (aged 10–18 years) who had gained over 10% of their baseline weight while on antipsychotics, 500 mg three times a day of metformin was given for 12 weeks in addition to psychotropics. The results of the study showed 15 patients lost weight, 3 gained weight, and one remained unchanged in weight. "
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    ABSTRACT: A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients. There is much speculation about the prevalence of weight gain and the degree of weight gain during acute and longitudinal treatment with these agents. There is newer literature looking at the etiology of this weight gain and the potential treatments being used to alleviate this side effect. The authors undertook a comprehensive literature review in order to present epidemiology, etiology, and treatment options of weight gain associated with antipsychotics, mood stabilizers, and antidepressants.
    Full-text · Article · Jan 2011 · Journal of obesity
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    • "They concluded that metformin, when given 500 mg twice daily, may be considered as an adjunct to diet and exercise in teens at risk for diabetes mellitus II (Freemark and Bursey 2001). Morrison and colleagues published a 12-week open-label study of metformin on 19 pediatric patients on psychotropic drugs who demonstrated significant weight loss (15 of 19; mean, À2.93 AE 3.13) on metformin (Morrison et al. 2002). Klein and colleagues, in their randomized, double-blind, placebo-controlled trial of metformin in children and adolescents taking atypical antipsychotics , found arrested weight gain, as well as improved insulin resistance (Klein et al. 2006). "
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    ABSTRACT: Metformin was assessed as an interventional medication for weight gain in children and adolescents taking atypical antipsychotic agents. A 12-week open-label trial was conducted to evaluate metformin's effectiveness and safety for weight management. Eleven subjects, ages 10-18 years, participated in the study. Each subject received metformin orally up to 2000 mg/day. Primary outcome measures included weight, body mass index (BMI), and waist circumference. Secondary outcome measures included serum glucose, insulin, and fasting lipid profile. Changes in weight, BMI, waist, and metabolic profile were obtained by using repeated measures of covariance. The mean reduction in weight, waist, BMI, serum glucose, and serum insulin was not statistically significant. However, 5 out of 11 patients lost weight (mean, -2.82 kg +/- 7.25), and overall the sample did not continue to gain weight. There was a significant decrease in triglyceride levels. Metformin was fairly well tolerated. Preliminary data suggests that metformin may safely and effectively improve the triglyceride profile. However, contrary to study hypotheses, weight, waist, and BMI reduction were not statistically significant. Future double-blind studies with larger sample sizes and of longer duration are warranted to assess more fully the safety and efficacy of this intervention.
    Full-text · Article · Jul 2009 · Journal of child and adolescent psychopharmacology
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