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J Clin Pharm Ther. 2011 Oct;36(5):537-45. doi: 10.1111/j.1365-2710.2011.01255.x. Epub 2011 Mar 21.

A systematic review of metformin to limit weight-gain with atypical antipsychotics.

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1
Graduate School of Clinical Pharmacy, Sookmyung Women's University, Seoul, Korea. yujeunglee@yahoo.com

Abstract

WHAT IS KNOWN AND OBJECTIVE:

Weight-gain is commonly reported in patients taking atypical antipsychotic agents. A systematic review was performed to evaluate the effectiveness of metformin for attenuation of weight-gain induced by atypical antipsychotic agents.

METHODS:

A PubMed database (1966-May 2010) search was conducted, using metformin, atypical antipsychotic and weight-gain as search terms. Review articles, letters and commentaries were excluded.

RESULTS AND DISCUSSION:

Thirteen trials were identified (eight randomized, double-blind, placebo-controlled trials, one crossover adult trial, one open-label uncontrolled adult trial, two open-label uncontrolled paediatric trials and one case report). Of the eight randomized, double-blind, placebo-controlled trials, three studied adult subjects and one studied children. Metformin was well tolerated. The heterogeneity of the trials did not justify meta-analytic pooling of outcomes, and we provide a best evidence synthesis.

WHAT IS NEW AND CONCLUSION:

There is limited evidence for the efficacy of metformin in limiting weight-gain induced by atypical antipsychotic agents. However, the evidence is weak and further well-powered randomized, double-blind, placebo-controlled studies of longer duration should be conducted to confirm the preliminary evidence and provide better estimates of effect.

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