Developing a metformin prescribing tool for use in adults with mental illness to reduce medication-related weight gain and cardiovascular risk

Australas Psychiatry. 2017 Aug;25(4):387-390. doi: 10.1177/1039856217695704. Epub 2017 Mar 1.

Abstract

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.

Results: A metformin prescribing tool was devised based on the literature, national cardiovascular and diabetes guidelines and Australian metformin prescribing recommendations. The metformin prescribing tool guides clinicians through the considerations required for appropriate selection of the target patient population and safe prescription of metformin.

Conclusions: A novel, easy-to-use, one-page reference has been developed for busy clinicians that can be laminated and displayed in consulting rooms and psychiatric inpatient units to address weight gain and obesity associated with antipsychotic medications in people with mental illness.

Keywords: cardiovascular risk factors; mental illness; metabolic syndrome; metformin; obesity; prescribing; second-generation antipsychotics; type 2 diabetes; weight gain.

MeSH terms

  • Antipsychotic Agents* / therapeutic use
  • Cardiovascular Diseases* / chemically induced
  • Cardiovascular Diseases* / prevention & control
  • Humans
  • Mental Disorders* / drug therapy
  • Metformin* / adverse effects
  • Metformin* / therapeutic use
  • Obesity
  • Risk Factors
  • Weight Gain* / drug effects

Substances

  • Antipsychotic Agents
  • Metformin