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metformin antipsychotic

Varuni Asanka de Silva, Chathurie Suraweera, Suhashini S Ratnatunga, Madhubashinee Dayabandara, Nimali Wanniarachchi, Raveen Hanwella
BACKGROUND: Most antipsychotics are associated with weight gain and other metabolic complications. Several randomized trials have shown metformin to be effective, but this still hasn't been included in clinical guidelines on managing antipsychotic induced weight gain. METHODS: All double blind placebo controlled trials assessing the efficacy of metformin in the treatment of antipsychotic induced weight gain were included. Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE were searched for the period January 2000-December 2015...
October 3, 2016: BMC Psychiatry
Evdokia Anagnostou, Michael G Aman, Benjamin L Handen, Kevin B Sanders, Amy Shui, Jill A Hollway, Jessica Brian, L Eugene Arnold, Lucia Capano, Jessica A Hellings, Eric Butter, Deepali Mankad, Rameshwari Tumuluru, Jessica Kettel, Cassandra R Newsom, Stasia Hadjiyannakis, Naomi Peleg, Dina Odrobina, Sarah McAuliffe-Bellin, Pearl Zakroysky, Sarah Marler, Alexis Wagner, Taylor Wong, Eric A Macklin, Jeremy Veenstra-VanderWeele
IMPORTANCE: Atypical antipsychotic medications are indicated for the treatment of irritability and agitation symptoms in children with autism spectrum disorder (ASD). Unfortunately, these medications are associated with weight gain and metabolic complications that are especially troubling in children and with long-term use. OBJECTIVE: To evaluate the efficacy of metformin for weight gain associated with atypical antipsychotic medications in children and adolescents with ASD (defined in the protocol as DSM-IV diagnosis of autistic disorder, Asperger disorder, or pervasive developmental disorder not otherwise specified), aged 6 to 17 years...
September 1, 2016: JAMA Psychiatry
Constance Mennella, Daniel P Dickstein
No abstract text is available yet for this article.
August 22, 2016: Journal of Child and Adolescent Psychopharmacology
Jorge Zimbron, Golam M Khandaker, Chiara Toschi, Peter B Jones, Emilio Fernandez-Egea
Metabolic complications are commonly found in people treated with clozapine. Reviews on the management of this problem have generally drawn conclusions by grouping different types of studies involving patients treated with various different antipsychotics. We carried out a systematic review and meta-analysis of pharmacological and non-pharmacological treatments for clozapine-induced obesity or metabolic syndrome. Two researchers independently searched PubMed and Embase for randomised controlled trials (RCTs) of treatments for clozapine-induced obesity or metabolic syndrome...
September 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Dan J Siskind, Janni Leung, Anthony W Russell, Daniel Wysoczanski, Steve Kisely
BACKGROUND: Although clozapine is the gold-standard for treatment refractory schizophrenia, it has the worst metabolic profile of all antipsychotics. This is partly mediated by clozapine's impact on glucagon-like peptide (GLP-1). There is an absence of robust evidence for effective treatments for clozapine associated weight gain and metabolic syndrome. Metformin, with its role in increasing GLP-1 may aid weight loss among people on clozapine. METHODS: We conducted a systematic-review and meta-analysis of metformin versus placebo for change in weight and metabolic syndrome for people on clozapine without diabetes mellitus...
2016: PloS One
Miguel López, Rubén Nogueiras, Manuel Tena-Sempere, Carlos Diéguez
AMP-activated protein kinase (AMPK) has a major role in the modulation of energy balance. AMPK is activated in conditions of low energy, increasing energy production and reducing energy consumption. The AMPK pathway is a canonical route regulating energy homeostasis by integrating peripheral signals, such as hormones and metabolites, with neuronal networks. Current evidence has implicated AMPK in the hypothalamus and hindbrain with feeding, brown adipose tissue thermogenesis and browning of white adipose tissue, through modulation of the sympathetic nervous system, as well as glucose homeostasis...
July 2016: Nature Reviews. Endocrinology
Chittaranjan Andrade
There are several reasons why metformin treatment may be considered for women in neuropsychiatric practice. These include prevention or attenuation of antipsychotic-associated weight gain, prevention or treatment of gestational diabetes mellitus (GDM), treatment of type 2 diabetes mellitus, and improvement of conception chances and pregnancy outcomes in the presence of polycystic ovarian disease (PCOD). This article examines the benefits and risks associated with metformin use during pregnancy. The available data suggest that metformin exposure during the first trimester is not associated with major congenital malformations; that metformin reduces the risk of early pregnancy loss, preeclampsia, preterm delivery, and GDM in women with PCOD; that metformin is associated with at least comparable benefits relative to insulin treatment in women with mild GDM; and that neurodevelopmental outcomes at age 1...
April 2016: Journal of Clinical Psychiatry
Jeffrey Rado, Stephanie von Ammon Cavanaugh
OBJECTIVE: This 24-week pilot study assessed the efficacy, tolerability, and safety of adjunctive metformin versus placebo for the prevention of olanzapine-associated weight gain in community-dwelling adult patients with schizophrenia, schizoaffective disorder, bipolar disorder, or major depression with psychotic features. METHODS: In a double-blind study, 25 patients were randomly assigned to receive 24 weeks of either olanzapine plus metformin or olanzapine plus placebo...
April 2016: Journal of Clinical Psychopharmacology
Robert Krysiak, Karolina Kowalcze, Witold Szkrobka, Boguslaw Okopien
BACKGROUND: In bromocriptine-treated hyperprolactinemic patients with impaired glucose tolerance, metformin was found to reduce plasma levels of prolactin. No previous study has investigated its impact on plasma prolactin in patients with drug-induced hyperprolactinemia. METHODS: The study included 20 women with antipsychotic-induced hyperprolactinemia and 12 normoprolactinemic women, who, because of coexisting glucose metabolism abnormalities, were treated for 6months with metformin...
May 2016: European Journal of Internal Medicine
Qi-Jing Bo, Zhi-Min Wang, Xian-Bin Li, Xin Ma, Chuan-Yue Wang, Jose de Leon
This systematic review examines adjunctive metformin therapy for the treatment of antipsychotic-induced hyperprolactinemia. A computerized search of databases in Chinese and the international databases in English provided three trials with a total of 325 patients including one randomized clinical trial (RCT) and two observational studies (single-group, before-after design). A meta-analysis could not be conducted. The quality of evidence ranged from "very low" to "moderate". Metformin patients had a significant decrease in serum prolactin level with a mean of 54...
March 30, 2016: Psychiatry Research
R-R Wu, F-Y Zhang, K-M Gao, J-J Ou, P Shao, H Jin, W-B Guo, P K Chan, J-P Zhao
Dyslipidemia is one of the most common adverse effects in schizophrenia patients treated with antipsychotics. However, there are no established effective treatments. In this study, data were pooled from two randomized, placebo-controlled trials, which were originally designed to examine the efficacy of metformin in treating antipsychotic-induced weight gain and other metabolic abnormalities. In total, 201 schizophrenia patients with dyslipidemia after being treated with an antipsychotic were assigned to take 1000 mg day(-1) metformin (n=103) or placebo (n=98) for 24 weeks, with evaluation at baseline, week 12 and week 24...
January 26, 2016: Molecular Psychiatry
Álvaro Enrique Arenas Borrero, Carlos Gómez Restrepo, Adriana Patricia Bohórquez Peñaranda, Ángela Vélez Traslaviña, Sergio Mario Castro Díaz, Luis Eduardo Jaramillo González, Jenny García Valencia
OBJECTIVE: To determine the most adequate strategies for the prevention and treatment of the acute adverse effects of the use of antipsychotics. METHODS: A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. A systematic literature search was carried out...
2014: Revista Colombiana de Psiquiatría
S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Ashcroft
STUDY QUESTION: What is the prevalence of different types of potentially hazardous prescribing in general practice in the United Kingdom, and what is the variation between practices? METHODS: A cross sectional study included all adult patients potentially at risk of a prescribing or monitoring error defined by a combination of diagnoses and prescriptions in 526 general practices contributing to the Clinical Practice Research Datalink (CPRD) up to 1 April 2013. Primary outcomes were the prevalence of potentially hazardous prescriptions of anticoagulants, anti-platelets, NSAIDs, β blockers, glitazones, metformin, digoxin, antipsychotics, combined hormonal contraceptives, and oestrogens and monitoring by blood test less frequently than recommended for patients with repeated prescriptions of angiotensin converting enzyme inhibitors and loop diuretics, amiodarone, methotrexate, lithium, or warfarin...
2015: BMJ: British Medical Journal
Varuni A de Silva, Madhubhashinee Dayabandara, Hiranya Wijesundara, Thushani Henegama, Heshan Gunewardena, Chathurie Suraweera, Raveen Hanwella
BACKGROUND: Antipsychotic-induced weight gain causes serious health problems. We investigated the efficacy and safety of metformin in treating antipsychotic-induced weight gain in South Asian patients. METHODS: Sixty six adult patients with schizophrenia or schizoaffective disorder treated, with atypical antipsychotics, and who had increased by more than 10% their pre treatment body weight, were randomly assigned to receive metformin or placebo in a double-blind study...
December 2015: Journal of Psychopharmacology
Cátia Jesus, Inês Jesus, Mark Agius
BACKGROUND: Psychiatric patients requiring therapy with antipsychotics have a greater incidence of becoming overweight or obese compared with the general population. Many of these patients are often treated with second-generation (atypical) antipsychotics (SGAs), which are associated with weight gain, dyslipidaemia, and other metabolic derangements. The most important and first line of treatment for the metabolic syndrome is lifestyle changes including diet and exercise. However, other approaches like the use of medication (e...
September 2015: Psychiatria Danubina
Gary J Remington, Celine Teo, Virginia Wilson, Araba Chintoh, Melanie Guenette, Zohra Ahsan, Adria Giacca, Margaret K Hahn
Antipsychotics (APs) are linked to diabetes, even without weight gain. Whether anti-diabetic drugs are efficacious in reversing the direct effects of APs on glucose pathways is largely undetermined. We tested two metformin (Met) doses to prevent impairments seen following a dose of olanzapine (Ola) (3 mg/kg); glucokinetics were measured using the hyperinsulinemic-euglycemic clamp (HIEC). Met (150 mg/kg; n=13, or 400 mg/kg; n=11) or vehicle (Veh) (n=11) was administered through gavage preceding an overnight fast, followed by a second dose prior to the HIEC...
November 2015: Journal of Endocrinology
Wei Zheng, Xian-Bin Li, Yi-Lang Tang, Ying-Qiang Xiang, Chuan-Yue Wang, Jose de Leon
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...
October 2015: Journal of Clinical Psychopharmacology
Sarah-Jo Sinnott, Jennifer M Polinski, Stephen Byrne, Joshua J Gagne
OBJECTIVES: To determine the concordance between two methods to measure drug exposure duration from pharmacy claim data. STUDY DESIGN AND SETTING: We conducted a cohort study using 2002-2007 US Medicaid data. Initiators of eight drug groups were identified: statins, metformin, atypical antipsychotics, warfarin, proton pump inhibitors (PPIs), angiotensin-converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs (ns-NSAIDs), and coxibs. For each patient, we calculated two measures of exposure duration using (1) observed days' supply available in US pharmacy claims and (2) the World Health Organisation's Defined Daily Dose (DDD) methodology...
January 2016: Journal of Clinical Epidemiology
Paria Hebrani, Ali Akhoundpour Manteghi, Fatemeh Behdani, Elham Hessami, Kambiz Akhavan Rezayat, Majid Nabizadeh Marvast, Amir Akhavan Rezayat
BACKGROUND: One of the major causes of death in schizophrenia is a metabolic syndrome. The clozapine has the highest rate of weight gain among antipsychotics. It has been shown that metformin can promote weight loss. We aimed to investigate the effect of metformin as an adjunctive therapy with clozapine to prevent metabolic syndrome in patients with schizophrenia. MATERIALS AND METHODS: A total of 37 patients consisting metformin group (19 cases) and a group of placebo consisting of 18 cases were evaluated...
April 2015: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Pornpoj Pramyothin, Lalita Khaodhiar
Youth receiving treatment with antipsychotics are particularly susceptible to weight gain, type 2 diabetes (T2D), and associated metabolic disorders, which is directly associated with excess morbidity and mortality in this vulnerable population. The risk of T2D is 2- to 3-fold that of the general population, starts early in the course of treatment, and reflects the effects of weight gain in conjunction with direct effects of antipsychotics on the hypothalamus, pancreatic beta cells, and insulin-sensitive peripheral tissues...
August 2015: Current Diabetes Reports
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