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metformin antipsychotic

Carlo Ripoli, Anna Paola Pinna, Faustina Podda, Roberta Zanni, Maria Giada Tronci, Anna Maria Nurchi
Second generation antipsychotics (SGA) are used in children for the treatment of various psychiatric diseases, including pervasive developmental disorders. These drugs can cause metabolic effects as hyperglycemia and diabetes. A 16-year-old young-boy, diagnosed with autism, developed diabetes mellitus type 1 whilst he was on treatment with olanzapine (started 4 months before), clomipramine, valproic acid and lithium. The hypothesis of druginduced diabetes imposed olanzapine interruption and clozapine initiation...
December 13, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
Wei Zheng, Qing-E Zhang, Dong-Bin Cai, Xin-Hu Yang, Gabor S Ungvari, Chee H Ng, Ren-Rong Wu, Yu-Tao Xiang
INTRODUCTION: Weight gain is a common antipsychotic (AP)-related adverse drug reaction (ADR) that can increase the risk of cardiovascular diseases and premature mortality. This meta-analysis examined the efficacy and tolerability of combining metformin and lifestyle intervention for AP-related weight gain in schizophrenia. METHODS: Randomized controlled trials (RCTs) with meta-analyzable data were searched and retrieved by 2 independent investigators. RevMan software (version 5...
February 27, 2018: Pharmacopsychiatry
Evdokia Anagnostou
PURPOSE OF REVIEW: The purpose of this manuscript is to review the evidence generated by clinical trials of pharmaceuticals in autism spectrum disorder (ASD), describe challenges in the conduct of such trials, and discuss future directions RECENT FINDINGS: Clinical trials in ASD have produced several compounds to adequately support the pharmacological treatment of associated symptom domains: attention deficit hyperactivity disorder (methylphenidate, atomoxetine, and alpha agonists), irritability/aggression (risperidone and aripiprazole), sleep (melatonin), and weight gain associated with atypical antipsychotic use (metformin)...
January 31, 2018: Current Opinion in Neurology
Robert Krysiak, Witold Szkróbka, Bogusław Okopień
Metformin was found to reduce elevated serum thyrotropin levels, and this effect was partially determined by endogenous dopaminergic tone. The aim of this study was to compare the effect of metformin treatment on hypothalamic-pituitary-thyroid axis activity in elderly women with subclinical hypothyroidism treated with antipsychotic agents and not receiving this drug. The study population consisted of 34 elderly women with subclinical hypothyroidism, 16 of whom received antipsychotic drugs. Because of coexistent type 2 diabetes, these women were treated with metformin (2...
December 18, 2017: Journal of Clinical Pharmacology
Q Le Bastard, G A Al-Ghalith, M Grégoire, G Chapelet, F Javaudin, E Dailly, E Batard, D Knights, E Montassier
BACKGROUND: Global prescription drug use has been increasing continuously for decades. The gut microbiome, a key contributor to health status, can be altered by prescription drug use, as antibiotics have been repeatedly described to have both short-term and long-standing effects on the intestinal microbiome. AIM: To summarise current findings on non-antibiotic prescription-induced gut microbiome changes, focusing on the most frequently prescribed therapeutic drug categories...
February 2018: Alimentary Pharmacology & Therapeutics
Kevin M Bozymski, Jessica A Whitten, Mary E Blair, Ashley M Overley, Carol A Ott
Antipsychotic medications carry an established lifetime risk of metabolic syndrome. This retrospective chart review evaluated feasibility of a metabolic monitoring clinical decision support tool (CDST) for weight, lipid, blood glucose, and blood pressure management of 163 clients in an early psychosis outpatient clinic over 2 years. Each parameter had at least 98 (60.1%) clients with a recorded value, the most being documented for weight with 112 (68.7%) clients. CDST adherence ranged from at least 54.3-100% for non-pharmacologic interventions (e...
November 11, 2017: Community Mental Health Journal
Benjamin L Handen, Evdokia Anagnostou, Michael G Aman, Kevin B Sanders, James Chan, Jill A Hollway, Jessica Brian, L Eugene Arnold, Lucia Capano, Craig Williams, Jessica A Hellings, Eric Butter, Deepali Mankad, Rameshwari Tumuluru, Jessica Kettel, Cassandra R Newsom, Naomi Peleg, Dina Odrobina, Sarah McAuliffe-Bellin, Sarah Marler, Taylor Wong, Alexis Wagner, Stasia Hadjiyannakis, Eric A Macklin, Jeremy Veenstra-VanderWeele
OBJECTIVE: A previous study reported on a 16-week placebo-controlled, randomized clinical trial (RCT) of metformin for weight stabilization in 61 children and adolescents 6 to 17 years old with autism spectrum disorder who were prescribed atypical antipsychotics. The present study describes the results of a 16-week open-label extension. METHOD: Fifty-two participants from the acute trial (85%) entered the extension; 22 had been on metformin during the initial RCT and 30 had been on placebo...
October 2017: Journal of the American Academy of Child and Adolescent Psychiatry
John T Walkup, Elizabeth Cottingham
No abstract text is available yet for this article.
October 2017: Journal of the American Academy of Child and Adolescent Psychiatry
Madhubhashinee Dayabandara, Raveen Hanwella, Suhashini Ratnatunga, Sudarshi Seneviratne, Chathurie Suraweera, Varuni A de Silva
Antipsychotic-induced weight gain is a major management problem for clinicians. It has been shown that weight gain and obesity lead to increased cardiovascular and cerebrovascular morbidity and mortality, reduced quality of life and poor drug compliance. This narrative review discusses the propensity of various antipsychotics to cause weight gain, the pharmacologic and nonpharmacologic interventions available to counteract this effect and its impact on adherence. Most antipsychotics cause weight gain. The risk appears to be highest with olanzapine and clozapine...
2017: Neuropsychiatric Disease and Treatment
Cassie Smith, Hannah Myles, Cherrie Galletly
OBJECTIVES: There is considerable evidence that metformin reduces weight gain associated with antipsychotic medication. The aim of this study was to develop an easy-to-use metformin prescribing tool in order to enable clinicians to prescribe metformin safely and confidently. METHODS: The authors undertook a survey of clinicians and reviewed the published literature and existing guidelines concerning the use of metformin to reduce weight gain in adults with mental illness...
August 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Alejandro Porras-Segovia, Amir Krivoy, Mark Horowitz, George Thomas, Mark Bolstridge, Dragos Ion, Sukhwinder S Shergill
Clozapine has proved to be an effective antipsychotic for the treatment of refractory schizophrenia - characterised by the persistence of symptoms despite optimal treatment trials with at least two different antipsychotics at adequate dose and duration - but its use is hampered by adverse effects. The development of clozapine-induced diabetes is commonly considered to arise as part of a metabolic syndrome, associated with weight gain, and thus evolves slowly. We present the case of an individual with refractory schizophrenia and metformin-controlled diabetes who developed rapid-onset insulin-dependent hyperglycaemia immediately after starting clozapine...
May 2017: BJPsych Open
Victoria Hendrick, Robert Dasher, Michael Gitlin, Mehrban Parsi
BACKGROUND: Patients taking antipsychotic medications are at high risk for weight gain, which in turn leads to poor health outcomes, nonadherence with treatment, and low self-esteem. METHODS: We reviewed published studies of pharmacologic interventions aimed at minimizing antipsychotic-induced weight gain. Treatments initiated prior to onset of weight gain were compared with those that started once weight gain already had occurred. RESULTS: Although data are limited, adjunctive medications for weight management appear to be more effective when initiated at or near the time when patients are first exposed to antipsychotic medications...
May 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Logan K Wink, Ryan Adams, Ernest V Pedapati, Kelli C Dominick, Emma Fox, Catherine Buck, Craig A Erickson
Antipsychotic treatment in youth with autism spectrum disorder (ASD) is becoming increasingly common, placing individuals at risk for antipsychotic-induced weight gain and associated complications. Metformin hydrochloride, a biguanide medication FDA-approved for treatment of type-2 diabetes in youth, may hold promise for treatment of antipsychotic-induced weight gain in youth with ASD. In this report we assess the long-term impact of metformin on antipsychotic-associated weight gain in a naturalistic sample of 53 youth with ASD...
July 2017: Journal of Autism and Developmental Disorders
Wei Zheng, Xin-Hu Yang, Dong-Bin Cai, Gabor S Ungvari, Chee H Ng, Nan Wang, Yu-Ping Ning, Yu-Tao Xiang
Hyperprolactinemia is a common and severe antipsychotic-induced adverse drug reaction. This meta-analysis of randomized controlled trials systematically examined the efficacy and safety of adjunctive metformin for antipsychotic-related hyperprolactinemia in schizophrenia patients. Two independent investigators searched, extracted, and synthesized data. Weighted mean differences and risk ratios with their 95% confidence intervals were calculated using random effect model. Four randomized controlled trials ( n=509) comparing adjunctive metformin ( n=253) with the control groups ( n=256), lasting 22...
May 2017: Journal of Psychopharmacology
Ekta Franscina Pinto, Biju George, Sagar Karia, Chittaranjan Andrade
No abstract text is available yet for this article.
April 2017: Journal of Psychopharmacology
Ranran Li, Jingping Zhao, Renrong Wu
No abstract text is available yet for this article.
December 2017: Schizophrenia Research
Chittaranjan Andrade
Metformin, a biguanide drug, is emerging as an important treatment option for the prevention or treatment of weight gain, type 2 diabetes mellitus, and the metabolic syndrome in psychiatric patients, especially those who require or receive antipsychotic drugs. Metformin treatment is commonly associated with gastrointestinal adverse effects; the risk of these is reduced by gradual dose uptitration, administration of the drug with meals, and use of a time-release formulation. Lactic acidosis, a potentially fatal complication of biguanide therapy, is very rare with metformin; the risk can be reduced by avoidance of its prescription in patients with impaired renal function, impaired liver function, cardiac failure, and certain other conditions...
November 2016: Journal of Clinical Psychiatry
Johanna Taylor, Brendon Stubbs, Catherine Hewitt, Ramzi A Ajjan, Sarah L Alderson, Simon Gilbody, Richard I G Holt, Prakash Hosali, Tom Hughes, Tarron Kayalackakom, Ian Kellar, Helen Lewis, Neda Mahmoodi, Kirstine McDermid, Robert D Smith, Judy M Wright, Najma Siddiqi
People with severe mental illness (SMI) have reduced life expectancy compared with the general population, which can be explained partly by their increased risk of diabetes. We conducted a meta-analysis to determine the clinical effectiveness of pharmacological and non-pharmacological interventions for improving glycaemic control in people with SMI (PROSPERO registration: CRD42015015558). A systematic literature search was performed on 30/10/2015 to identify randomised controlled trials (RCTs) in adults with SMI, with or without a diagnosis of diabetes that measured fasting blood glucose or glycated haemoglobin (HbA1c)...
2017: PloS One
Chittaranjan Andrade
Children and adolescents who are exposed to antipsychotic medication are at increased risk of weight gain and metabolic dysregulation. Metformin, which has demonstrated efficacy for these adverse treatment outcomes in adult samples, has been examined in pediatric samples, as well. Case reports, 2 uncontrolled studies, and 2 (out of 3) randomized controlled trials have demonstrated that metformin (1,000-1,700 mg/d) treatment for up to 16 weeks is associated with statistically and clinically significant weight loss...
October 2016: Journal of Clinical Psychiatry
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