The Optimal Dosage and Duration of Metformin for Prevention and Treatment of Antipsychotic-Induced Weight Gain: An Updated Systematic Review and Meta-Analysis.

IF 5.3 1区医学 Q1 PSYCHIATRY

Schizophrenia Bulletin Pub Date : 2024-11-07 DOI:10.1093/schbul/sbae173

Tzu-Rong Peng, Jou-An Chen, Jen-Ai Lee, Chih-Pin Hsing, Ming-Chia Lee, Shih-Ming Chen

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引用次数: 0

Abstract

Background: Weight gain and metabolic complications are substantial adverse effects associated with second-generation antipsychotics. However, comprehensive guidelines for managing antipsychotic-induced weight gain are lacking.

Methods: This review included all double-blind, placebo-controlled studies investigating metformin's effectiveness in addressing antipsychotic-related weight gain. We systematically searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, Google Scholar, and ClinicalTrials.gov for relevant studies from the inception to 2024. A random-effects model was used for the meta-analysis.

Results: This meta-analysis, including 20 studies with 1070 patients, revealed that metformin significantly surpassed placebo in attenuating weight gain in patients receiving antipsychotics. The mean weight change with metformin was -3.32 kg [95% confidence interval (CI): -4.57 to -2.07]. Additionally, metformin use resulted in a marked decrease in body mass index [-1.24 kg/m2 (95% CI: -1.70 to -0.77)]. Metformin could maintain the effects from 12 to 24 weeks.

Conclusions: This updated meta-analysis investigated the durations and dosages of metformin use in patients with schizophrenia experiencing antipsychotic-induced weight gain. The findings highlight the need for additional large-scale research to validate our findings.

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二甲双胍预防和治疗抗精神病药物所致体重增加的最佳剂量和持续时间：最新系统综述与元分析》。

背景：体重增加和代谢并发症是第二代抗精神病药物的主要不良反应。然而，目前尚缺乏管理抗精神病药物引起的体重增加的综合指南：本综述纳入了所有双盲安慰剂对照研究，这些研究调查了二甲双胍在应对抗精神病药物相关体重增加方面的有效性。我们系统地检索了 PubMed、Embase、Cochrane Central Register of Controlled Trials、Google Scholar 和 ClinicalTrials.gov 中从开始到 2024 年的相关研究。荟萃分析采用随机效应模型：该荟萃分析包括20项研究，共1070名患者，结果显示，二甲双胍在减轻接受抗精神病药物治疗的患者体重增加方面明显优于安慰剂。二甲双胍的平均体重变化为-3.32千克[95%置信区间（CI）：-4.57至-2.07]。此外，二甲双胍还能显著降低体重指数[-1.24 kg/m2 (95% CI: -1.70 to -0.77)]。二甲双胍可将疗效维持12至24周：这项最新的荟萃分析调查了抗精神病药物导致体重增加的精神分裂症患者服用二甲双胍的持续时间和剂量。研究结果表明，有必要进行更大规模的研究来验证我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Schizophrenia Bulletin 医学-精神病学

CiteScore

11.40

自引率

6.10%

发文量

163

审稿时长

4-8 weeks

期刊介绍： Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.