Hormonal
Metformin is an effective and well-tolerated adjunctive pharmacological intervention for treating and preventing antipsychotic-induced weight gain in patients with severe mental illness.
If you are taking antipsychotics like Clozapine or Olanzapine and gaining weight, ask your doctor about adding Metformin. It is the most studied off-label option for this specific problem. Studies show it helps reduce weight and prevents further gain, though you may experience some stomach issues initially. It is generally well-tolerated compared to other alternatives.
To conclude, evidence indicates that metformin is effective in the treatment of AiWG and is well-tolerated. Future randomized placebo-controlled trials are necessary to confirm the promising results of metformin for the prevention of AiWG.
Why this rating
Supported by multiple meta-analyses and retrospective cohort studies, though the authors call for more RCTs for prevention.
Source
Antipsychotic‐induced weight gain: Is the weight over? New guidelines needed
Nini de Boer et al. · Acta Psychiatrica Scandinavica · 2022
DOI 10.1111/acps.13485
More from this paper
- Switching antipsychotics to Aripiprazole results in significant weight reduction, but adding Aripiprazole to an existing regimen is not recommended due to increased risks of agitation and akathisia.Good
- Topiramate is effective for reducing antipsychotic-induced weight gain but is limited by poor tolerability, specifically cognitive difficulties and paresthesia.Good
- GLP-1 agonists (Liraglutide and Semaglutide) are promising interventions for reducing antipsychotic-induced weight gain, with Semaglutide showing superior efficacy to Liraglutide in general obesity populations, though evidence in SMI is still emerging.Moderate
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →