<p>Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program</p>

Abstract

Background: Metformin is commonly prescribed to manage polycystic ovary syndrome (PCOS), which is one of the most common endocrine disorders among women of childbearing age and is associated with high prevalence rates of depression and anxiety.Objective: This study's objective was to determine the impact of prescribed metformin on depression and anxiety levels of patients with PCOS. Methods: This prospective, multi-center, cohort study examined the impact of prescribed metformin on the depression and anxiety of women with PCOS in four gynecology clinics in Saudi Arabia and Jordan. The women had recently been prescribed metformin along with lifestyle modifications, such as diet and exercise, and were compared to another group of women with PCOS who were prescribed lifestyle modifications only. Depression and anxiety were assessed at baseline and three months later using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scale, respectively. Health-related quality of life was measured using the Short Form Health Survey (SF-36). Multiple logistic regression analyses were conducted to examine the impact of metformin on depression and anxiety. Results: Eighty-six women participated in the study: 53 were prescribed metformin with lifestyle modifications, and 33 were prescribed lifestyle modifications only. The women on metformin had 70% lower odds of having major depression (PHQ-9≥10) (OR=0.302, P=0.045); however, no significant effect of metformin on anxiety (GAD-7≥10) was found. Conclusion: Metformin may have a role in the management of depression symptoms among patients with PCOS; however, its potential antidepressant effect should be further examined in randomized double-blind placebo-controlled clinical trials.

Intermittent Fasting, Dietary Modifications, and Exercise for the Control of Gestational Diabetes and Maternal Mood Dysregulation: A Review and a Case Report

“…Fasting mimetics, such as rapamycin and metformin, are used to influence signaling involved in dietary restriction without actual calorie restriction [ 87 ]. Metformin is reported to mitigate symptoms of depression and treat common endocrine disorders among women of childbearing age (e.g., polycystic ovary syndrome) [ 89 ].…”

The effect of polycystic ovarian syndrome on the mental health of women of reproductive age

“…23 Early screening allows for adequate treatment to begin as soon as possible and is important for the prevention of a worse mental state which will affect the patient's quality of life. 7 Lifestyle changes like a healthy diet and physical changes are advised as first-line treatment options for PCOS, both interventions have been linked to a reduction in depression and elevated quality of life. 24 Physical activity reduces insulin resistance, improves body image and the metabolic and reproductive features of PCOS, and group exercise has been linked to better mental health outcomes since it is a great way to have a form of accountability and support.…”

“…4,5 PCOS can also increase women's risk of type 2 diabetes, cardiovascular disease, infertility, anxiety and depression, and poor health-related quality of life. [6][7][8] The signs and symptoms usually develop in menarche and they vary from woman to woman. 9,10 These changes may be in response to obesity causing irregular or prolonged cycles with more than 35-day intervals.…”

“…4 PCOS has no cure but its symptoms can be managed with drugs like bupropion, naltrexone, pioglitazone, metformin, and lifestyle changes including a healthy diet and regular physical exercise. 5,7…”

Reduction of Depression in Diabetes: A New Pleiotropic Action of Metformin?

“…A prospective, multi-centre cohort study conducted in four gynaecology clinics showed that women with polycystic ovary syndrome (PCOS) receiving metformin combined with lifestyle modifications improved their mental well-being [ 6 ]. Moreover, among elderly subjects with diabetes, depression was not uncommon, while its presence was reduced by metformin therapy [ 7 ].…”