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Only 1 of patients in the metformin group, and 3 of 98 patients in the placebo group discontinued before week 12 because of loss to follow-up, and 7 patients 3 metformin and 4 placebo discontinued before week 24 because of loss to follow-up.

ILLUSTRATIVE CASE

Although the first trial STUDY 1, NCT; recruitment, — was to examine the efficacy of metformin for treatment of antipsychotic-induced dyslipidemia; the second trial STUDY 2, NCT was initially designed to investigate the efficacy of metformin in the treatment of antipsychotic-induced amenorrhea and weight gain.

A systematic review of mortality in schizophrenia: The beneficial effects of better compliance with medication and reduced suicide rates due to second generation antipsychotics are offset by the deaths due to antipsychotic induced weight gain [ 9 ]. This was consistent with the difference in the mean of total cholesterol between metformin and placebo group.

We found that metformin treatment was effective in improving antipsychotic-induced dyslipidemia and insulin resistance, and the effects improving antipsychotic-induced insulin resistance appeared earlier than the reducing dyslipidemia.

RH participated in the design of the study, data analysis and drafted the manuscript. Serum lactic acid levels, liver and renal function tests, and electrocardiogram results remained normal in all patients throughout the course of the treatment, and there were no episodes of vomiting or lactic acidosis.

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Ten of the randomized patients either discontinued the study or were lost to follow up, but all patients were included in the analysis. The effects of metformin treatment on reducing insulin or insulin resistance, and dyslipidemia occurred in a time-sequence manner.

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Only one RCT included an arm of lifestyle modification [ 28 ]. Suspecting that the effect of metformin treatment on dyslipidemia may act through the improvement of insulin resistance, we examined further treatment effect on dyslipidemua while controlling for the level of insulin resistance, measured by insulin resistance index.

All double blind placebo controlled trials assessing the efficacy of metformin in the treatment of antipsychotic induced weight gain were included. Fasting blood samples were drawn after confirmation with patients or their caregivers. Antipsychotics exhibit variability in the amount of weight gain and risk for diabetes they cause TABLE 1.

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Subgroup analysis was carried out for weight and BMI comparing adults and children. A randomized, double-blind, placebo-controlled trial of metformin treatment of weight gain associated with initiation of atypical antipsychotic therapy in children and adolescents. Olanzapine is linked to clinically significant body weight gain ranging from 0. De Silva et al. Warn them about possible gastrointestinal adverse effects of metformin, which tend to lessen or disappear with time.

Molecular mechanism of action of metformin: However, there is a relative lack of interventions to control antipsychotic-induced dyslipidemia. You are not being rude at all.

Efficacy and safety of combination therapy with vildagliptin and metformin versus metformin up-titration in Chinese patients with type 2 diabetes mellitus: A slight increase in weight loss was associated with the use of metformin in this study. The evidence that metformin treatment improve the lipid profile in schizophrenia patients is to a certain degree independent of insulin resistance.

Metformin for weight control in pediatric patients on atypical antipsychotic medication. J Child Adolesc Psychopharmacol. Cochrane Database Syst Rev. Once these metabolic changes have occurred metformin may be less effective in preventing or reversing weight gain.

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