Research Study On Metformin, A Drug And Its Use For Antipsychotic Treatment

1054 words - 5 pages

Background
Weight-gain, which is associated with antipsychotic treatments, is one of the most important concerns in a psychiatric management. Not only it creates self-esteem issues, but it also leads to serious health problems such as cardiovascular diseases or early death.1 As a matter of fact, there are no effective pharmacological treatments to facilitate weight-loss in psychiatric patients. However, there are some current studies showing Metformin can reduce metabolic rate. As a result, it is considered as a drug of choice in this specific population. Metformin is a biguanide; and its mechanism of action is reducing both hepatic glucose production and intestinal glucose absorption.2 It ...view middle of the document...

3 It involved 72 patients, who were from 18 to 60 years old and diagnosed with first episode schizophrenia.3 The inclusion criteria were participants gained more than 7% of their weight after they had been on antipsychotic drugs within the first year of treatment when they were either discharged from inpatient or first seen in the clinic.3 They also had some stable improvement on therapeutics outcomes and were on only one antipsychotic medication with the dose unchanged by more than 25% over the past 3 months.3 Besides, participants were excluded from the trial if they had cardiovascular, pulmonary or neurological diseases, renal or liver impairment, diabetes, and arthritis.3
The trial was designed with 32 patients in a study group and 34 patients in a placebo group.3 Both groups were given 250 mg of Metformin or placebo twice daily on the first three days, then they continued with 500 mg tablets two times a day thereafter.3 During the trial, antipsychotic drug dosage and regimen remained the same. Participants were not involved in any life-style modification and did not differ in baseline measurements, including demographics, medical history, and physical examination.3
The primary endpoint was changed in body weight. In addition, changes in body mass index, insulin resistance index, fasting glucose, and insulin were the second endpoints. After 12 weeks of treatment, there was a significant difference in the primary outcome, p<0.001.3 Patients in the placebo group gained weight by 3.9%.3 In contrast, patients in the Metformin group lost weight by 5.1%.3 Also, there was a significant difference between the two groups for the second endpoints of body mass index, insulin, and insulin resistance index, p<0.001.3 The mean insulin resistance index went down by 3.5% in the study group and went up by 0.4% in the placebo group.3 There was no difference in fasting glucose.3
There were some adverse events such as nausea, extrapyramidal symptoms, insomnia, somnolence, and dry mouth.3 However, they were reported to be no significant differences. During the 12-week follow-up therapy, 6 patients were lost because of the adverse drug reaction.3 Regarding the study results, it was analyzed by intention to treat principles. Every...

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