Metformin: Prevention and Treatment of Antipsychotic-Induced Weight Gain

Generali, Joyce A.; Cada, Dennis J.

doi:10.1310/hpj4809-734

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…In fact, the proportion of patients with type 2 diabetes mellitus was not different between the groups. Often, metformin is started prophylactically in clinical practice when prescribing atypical antipsychotics, given its beneficial effects on weight and insulin sensitivity (17)(18)(19). Although impaired glucose tolerance is a known driver for the development of NAFLD and could have contributed to the higher steatosis scores, HbA1c levels were similar between the groups, rendering this hypothesis less likely.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic Medications Are Associated With Increased Liver Disease Severity in Pediatric Nonalcoholic Fatty Liver Disease

Mouzaki¹,

Yodoshi²,

Arce‐Clachar³

et al. 2019

J. pediatr. gastroenterol. nutr.

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Objectives: The aim of the study was to determine whether pediatric patients with nonalcoholic fatty liver disease (NAFLD) exposed to psychotropic medications have more severe liver disease compared to their counterparts who are not on these medications. We hypothesize that use of psychotropic agents is associated with liver disease severity. Methods: Children and adolescents with biopsy-confirmed NAFLD were included in this study. Histology data, detailed clinical information, and results of serum biochemistries performed within 3 months of the liver biopsy were collected retrospectively. Univariate and multivariate modeling was used to determine differences between the groups and to control for confounders. Results: A total of 228 patients were included, 17 (8%) of whom where on psychotropic medications at the time of the liver biopsy. Patients on psychotropic medications were more likely to also be on metformin (53% vs 18%, P < 0.01) and antihypertensive medications (29% vs 8%, P < 0.01) compared to children with NAFLD who were not on psychotropic agents. There were no differences in regards to biochemical evidence of liver injury, insulin resistance, and dyslipidemia between the groups. On histology, however, the use of psychotropic medications was associated with increased steatosis severity (score 2.4 vs 1.9, P = 0.04) and increased likelihood of having an NAFLD Activity Score ≥5 (seen in 59% vs 35% or patients; P = 0.05, respectively). Conclusions: In this large cohort of children with biopsy-confirmed NAFLD, the use of psychotropic medications was associated with increased liver disease severity. Exposure to psychotropic agents should be considered when risk stratifying children with NAFLD.

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Section: Discussionmentioning

confidence: 99%

Psychotropic Medications Are Associated With Increased Liver Disease Severity in Pediatric Nonalcoholic Fatty Liver Disease

Mouzaki¹,

Yodoshi²,

Arce‐Clachar³

et al. 2019

J. pediatr. gastroenterol. nutr.

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“…Studies have shown that use of antipsychotics increase the risk of weight gain, dyslipidemia and diabetes. Weight gain and abdominal adiposity which is directly associated with insulin resistance, dyslipidemia and risk of diabetes may be induced by second generation antipsychotics [61,62]. Stimulation of appetite, reducing physical activity and impairing metabolic regulation is the mechanism of antipsychotics induced weight gain [63].…”

Section: Metformin In Medication Induced Weight Gainmentioning

confidence: 99%

Metformin: Pros and Cons

Sivadasan¹,

Subramanian²,

Rajasekaran³

2021

Metformin - Pharmacology and Drug Interactions

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Metformin was approved for the treatment of Type 2 Diabetes Mellitus in 1958 for UK, in 1972 for Canada and in 1995 by FDA in USA. Metformin is the drug of choice for patients who are obese and have type 2 diabetes mellitus. Though metformin was at first proven to treat hyperglycemia, many other uses of metformin are proven to be effective. It is also used for gestational diabetes mellitus, obesity, hyper secretion of ovarian androgen, poly-cystic ovary syndrome (PCOS), anti-psychotic therapy induced weight gain, cancer treatment and anti-aging. Metformin causes a decrease in appetite thus known to act on obesity. The other action of metformin is reduction of circulating levels of insulin and insulin like growth factor 1 (IGF-1) which is associated with anticancer action. There are ongoing researches about the effect of metformin on anti-aging properties and proved that metformin is linked with anti-aging factors. Three main factors that are related with aging are oxidation, glaciation and methylation. Metformin as all drugs, have unwanted effects as well. Many side effects of metformin are considered mild where lactic acidosis and vitamin B12 deficiency happens to be the major.

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“…In this study, the metformin group showed continued improvement in weight from initial study baseline; however this effect seems to be driven by participants age 45 and older at randomization . Metformin has also been shown to be mildly beneficial in weight reduction when added to regimens that include medications that cause weight gain, such as antipsychotic medications . The inclusion of metformin along with an antipsychotic also had additional benefits as it decreased prolactin levels, which increase with antipsychotic treatment and result in side effects such as menstrual irregularities and galactorrhea .…”

Section: Clinical Uses In Pediatricsmentioning

confidence: 99%

Metformin; a review of its history and future: from lilac to longevity

2017

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Metformin is a widely prescribed medication that has been used to treat children with type 2 diabetes in the United States for the past 15 years. Metformin now has a variety of clinical applications in pediatrics, and its potential clinical uses continue to expand. In addition to reviewing the current understanding of its mechanisms of action including the newly discovered effects on the gastrointestinal tract, we will also discuss current clinical uses in pediatrics, including in type 1 diabetes. Finally, we examine the existing state of monitoring for metformin efficacy and side effects and discuss prospective future clinical uses.

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Metformin: Prevention and Treatment of Antipsychotic-Induced Weight Gain

Cited by 3 publications

References 7 publications

Psychotropic Medications Are Associated With Increased Liver Disease Severity in Pediatric Nonalcoholic Fatty Liver Disease

Psychotropic Medications Are Associated With Increased Liver Disease Severity in Pediatric Nonalcoholic Fatty Liver Disease

Metformin: Pros and Cons

Metformin; a review of its history and future: from lilac to longevity

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