Your browser doesn't support javascript.
loading
Metformin co-commencement at time of antipsychotic initiation for attenuation of weight gain: a systematic review and meta-analysis.
Yu, Ou; Lu, Mengyao; Lai, Terence K Y; Hahn, Margaret; Agarwal, Sri Mahavir; O'Donoghue, Brian; Ebdrup, Bjørn H; Siskind, Dan.
Afiliación
  • Yu O; Faculty of Medicine, University of Queensland, Mayne Medical School, 20 Weightman St, Herston, QLD 4006, Australia.
  • Lu M; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
  • Lai TKY; Addiction and Mental Health Service, Metro South Health, Brisbane, QLD, Australia.
  • Hahn M; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
  • Agarwal SM; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
  • O'Donoghue B; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • Ebdrup BH; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
  • Siskind D; Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
Ther Adv Psychopharmacol ; 14: 20451253241255476, 2024.
Article en En | MEDLINE | ID: mdl-38827016
ABSTRACT

Background:

Antipsychotic medications are associated with weight gain and metabolic derangement. However, comprehensive evidence for the efficacy of co-commenced pharmacological treatments to mitigate initial weight gain is limited. Metformin has been shown to be effective in reducing weight among people on antipsychotic medications who are already overweight, but the potential benefits of metformin co-commencement in mitigating antipsychotic-induced weight gain has not been systematically reviewed.

Method:

We conducted a systematic review of PubMed, EMBASE, PsychInfo, CINAHL, the Cochrane database, and China National Knowledge Infrastructure from inception to 18 November 2023. We undertook a meta-analysis of concomitant commencement of metformin versus placebo for attenuation of weight gain and metabolic syndrome for people with schizophrenia commencing a new antipsychotic.

Results:

Fourteen studies from Australia, United States, Venezuela, and China with 1126 participants were included. We found that metformin was superior to placebo in terms of attenuating weight gain (-3.12 kg, 95% CI -4.22 to -2.01 kg). Metformin also significantly attenuated derangement of fasting glucose levels, total cholesterol, and total triglyceride levels. Sensitivity analysis on study quality, duration, and antipsychotic agent did not impact the results. Meta-analysis was also conducted on adverse drug reactions (ADR) reported in each study which showed no significant difference in ADR incidence between metformin and placebo groups. Subgroup analysis on antipsychotic-naïve participants and participants switching to new antipsychotic did not impact the results.

Conclusion:

Metformin led to statistically significant and clinically meaningful attenuation of weight gain as well as attenuation of several other metabolic parameters when commenced concomitantly with antipsychotic medications. Co-commencement of metformin with antipsychotic medications, where tolerated, should be considered in the clinical setting with aim to improve long-term cardiometabolic outcomes for patients with long-term need of antipsychotic treatments.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ther Adv Psychopharmacol Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ther Adv Psychopharmacol Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido