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The Adjunctive Use of Metformin to Treat or Prevent Atypical Antipsychotic-Induced Weight Gain: A Review

Khan, Ahsan Y. MD*; Macaluso, Matthew DO*; Mchale, Robert J. MD, MSc*; Dahmen, Megan M. PHARMD, BCPP; Girrens, Kathrine MD, PhD*; Ali, Faryal MBBS

Journal of Psychiatric Practice®: September 2010 - Volume 16 - Issue 5 - p 289-296
doi: 10.1097/01.pra.0000388624.91039.a3

Patients with schizophrenia have a greater incidence of being overweight or obese compared with the general population. Such individuals are often treated with second-generation (atypical) antipsychotics (SGAs), which are associated with weight gain, dyslipidemia, and other metabolic derangements. As a result, frequent monitoring of weight and other metabolic parameters is recommended. In addition, several pharmacologic strategies to help prevent or reduce SGA-induced weight gain have been proposed. Despite this, clinicians often struggle to manage obesity and metabolic issues in such patients. Metformin has attracted attention as a potential treatment option because it is thought to result in weight reduction and improved glycemic control in obese patients with and without type 2 diabetes mellitus. This article focuses on relevant pharmacologic aspects of metformin and reviews currently available evidence on the use of metformin as an augmentation agent for the treatment or prevention of SGA-induced weight gain.

*University of Kansas School of Medicine-Wichita

Via Christi Regional Medical Center, Wichita, KS

Please send correspondence to: Ahsan Y. Khan, MD, Associate Professor, Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine-Wichita, 1010 N. Kansas, Wichita, KS 67214.

Disclosure: Dr. Khan is on the speakers' panel for Pfizer and Merck. The other authors declare no conflicts of interest.

© 2010 Lippincott Williams & Wilkins, Inc.