A systematic review of metformin to limit weight-gain with atypical antipsychotics
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.
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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