Metformin for Weight Control in Pediatric Patients on Atypical Antipsychotic Medication

Shin, Lauren; Bregman, Hallie; Breeze, Janis L.; Noyes, Nancy; Frazier, Jean A.

doi:10.1089/cap.2008.094

Cited by 44 publications

(29 citation statements)

References 17 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The findings suggest that metformin is an effective, safe, and well-tolerated therapy for weight gain and metabolic abnormalities induced by antipsychotics. Furthermore, most case reports [51][52][53] and open-label studies [54][55][56][57][58] in patients treated with antipsychotics also showed that adjunctive metformin was associated with a decrease in weight gain and reduction in metabolic abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Metformin for Weight Gain and Metabolic Abnormalities Associated With Antipsychotic Treatment

Zheng

Tang

et al. 2015

Journal of Clinical Psychopharmacology

View full text Add to dashboard Cite

This meta-analysis examined the effectiveness and safety of metformin to prevent or treat weight gain and metabolic abnormalities associated with antipsychotic drugs. We systematically searched in both English- and Chinese-language databases for metformin randomized controlled clinical trials (RCTs) using placebo in patients taking antipsychotics. Twenty-one RCTs (11 published in English and 10 in Chinese) involving 1547 subjects (778 on metformin, 769 on placebo) were included in this meta-analysis. Metformin was significantly superior to placebo (standard mean differences, -0.69 to -0.51; P = 0.01-0.0001) in the primary outcome measures (body weight, body mass index, fasting glucose, fasting insulin, triglycerides, and total cholesterol). Metformin was significantly superior to placebo in some secondary outcome measures but not in others. Significantly higher frequencies of nausea/vomiting and diarrhea were found in the metformin group, but no differences were found in other adverse drug reactions. In the metformin group, the frequency of nausea/vomiting was 14%, and of diarrhea, 7%. Subgroup and sensitivity analyses demonstrated that primary outcomes were influenced by ethnicity, treatment style (intervention vs prevention), metformin dose, study duration, and mean age. Body weight standard mean difference was -0.91 (confidence interval [CI], -1.40 to -0.41) in 3 prevention RCTs in naive patients, -0.66 (CI, -1.02 to -0.30) in 5 intervention RCTs during the first year, and -0.50 (CI, -0.73 to -0.27) in 9 intervention RCTs in chronic patients. This meta-analysis suggests that adjunctive metformin is an effective, safe, and reasonable choice for antipsychotic-induced weight gain and metabolic abnormalities.

show abstract

Section: Discussionmentioning

confidence: 99%

Metformin for Weight Gain and Metabolic Abnormalities Associated With Antipsychotic Treatment

Zheng

Tang

et al. 2015

Journal of Clinical Psychopharmacology

View full text Add to dashboard Cite

show abstract

“…Another meta-analysis of 32 placebocontrolled pharmacologic intervention trials involving 1482 subjects suggested that metformin had the most promising effect on weight loss, followed by fenfluramine, sibutramine, topiramate, and reboxetine [19]. Other clinical trials also showed a similar effect of metformin in attenuating SGA-induced weight gain [18,[20][21][22][23]. A recent study reported that both metformin and berberine treatment did not affect food intake, but significantly prevented olanzapine-induced brown fat loss [24].…”

Section: Introductionmentioning

confidence: 99%

Ameliorating antipsychotic-induced weight gain by betahistine: Mechanisms and clinical implications

Lian

Huang

Pai

et al. 2016

Pharmacological Research

View full text Add to dashboard Cite

Second generation antipsychotic drugs (SGAs) cause substantial body weight gain/obesity and other metabolic side-effects such as dyslipidaemia. Their antagonistic affinity to the histaminergic H1 receptor (H1R) has been identified as one of the main contributors to weight gain/obesity side-effects. The effects and mechanisms of betahistine (a histaminergic H1R agonist and H3 receptor antagonist) have been investigated for ameliorating SGA-induced weight gain/obesity in both animal models and clinical trials. It has been demonstrated that co-treatment with betahistine is effective in reducing weight gain, associated with olanzapine in drug-naïve patients with schizophrenia, as well as in the animal models of both drug-naïve rats and rats with chronic, repeated exposure to olanzapine. Betahistine co-treatment can reduce food intake and increase the effect of thermogenesis in brown adipose tissue by modulating hypothalamic H1R-NPY-AMPKα (NPY: neuropeptide Y; AMPKα: AMP-activated protein kinase α) pathways, and ameliorate olanzapineinduced dyslipidaemia through modulation of AMPKα-SREBP-1-PPARα-dependent pathways (SREBP-1: Sterol regulatory element binding protein 1; PPARα: Peroxisome proliferator-activated receptor-α) in the liver. Although reduced locomotor activity was observed from antipsychotic treatment in rats, betahistine did not affect locomotor activity. Importantly, betahistine co-treatment did not influence the effects of antipsychotics on serotonergic receptors in the key brain regions for antipsychotic therapeutic efficacy. However, betahistine co-treatment reverses the upregulated dopamine D2 binding caused by chronic olanzapine administration, which may be beneficial in reducing D2 supersensitivity often observed in chronic antipsychotic treatment. Therefore, these results provide solid evidence supporting further clinical trials in treating antipsychotics-induced weight gain using betahistine in patients with schizophrenia and other mental disorders.

show abstract

“…In a 12-week, open-label trial of metformin for the treatment of weight gain and metabolic profiles in pediatric patients, Shin et al (50) studied 11 children and adolescents ages 10–18 years who received metformin orally up to 2000 mg/day. They reported no statistically significant reductions in mean weight, waist circumference, BMI, serum glucose, and insulin even though 5 of the 11 subjects lost weight.…”

Section: Introductionmentioning

confidence: 99%

A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics

Nwosu

Meltzer

Maranda

et al. 2011

Journal of Pediatric Endocrinology and Metabolism

Self Cite

View full text Add to dashboard Cite

, "A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics" (2011 AbstractSecond-generation antipsychotic (SGA) medications introduced about 20 years ago are increasingly used to treat psychiatric illnesses in children and adolescents. There has been a fi ve-fold increase in the use of these medications in U.S. children and adolescents in the past decade. However, there has also been a parallel rise in the incidence of side effects associated with these medications, such as obesity, dyslipidemia, insulin resistance, and diabetes mellitus. Despite the severity of these complications and their fi nancial impact on the national healthcare budget, there is neither a clear understanding of the mechanisms contributing to these side effects nor the best ways to address them. Studies that examined lifestyle modifi cation and pharmaceutical agents have yielded mixed results. Therefore, clinical studies using agents, such as vitamin D, which are inexpensive, readily available, with low side effects profi le, and have mechanisms to counteract the metabolic side effects of SGA agents, are warranted. Vitamin D is a prohormone with skeletal and extraskeletal properties that could potentially reduce the severity of these metabolic side effects. Its role as an adjunctive therapy for the management of metabolic side effects of SGA agents has not been adequately studied. Effective strategies to curb these side effects will improve the overall health of youths with psychiatric illnesses who receive SGAs. Herein we present a pilot study on the use of vitamin D in patients on treatment with SGAs.

show abstract

Metformin for Weight Control in Pediatric Patients on Atypical Antipsychotic Medication

Cited by 44 publications

References 17 publications

Metformin for Weight Gain and Metabolic Abnormalities Associated With Antipsychotic Treatment

Metformin for Weight Gain and Metabolic Abnormalities Associated With Antipsychotic Treatment

Ameliorating antipsychotic-induced weight gain by betahistine: Mechanisms and clinical implications

A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics

Contact Info

Product

Resources

About