Metformin for weight control in pediatric patients on atypical antipsychotic medication.
OBJECTIVE
Metformin was assessed as an interventional medication for weight gain in children and adolescents taking atypical antipsychotic agents.


METHODS
A 12-week open-label trial was conducted to evaluate metformin's effectiveness and safety for weight management. Eleven subjects, ages 10-18 years, participated in the study. Each subject received metformin orally up to 2000 mg/day. Primary outcome measures included weight, body mass index (BMI), and waist circumference. Secondary outcome measures included serum glucose, insulin, and fasting lipid profile. Changes in weight, BMI, waist, and metabolic profile were obtained by using repeated measures of covariance.


RESULTS
The mean reduction in weight, waist, BMI, serum glucose, and serum insulin was not statistically significant. However, 5 out of 11 patients lost weight (mean, -2.82 kg +/- 7.25), and overall the sample did not continue to gain weight. There was a significant decrease in triglyceride levels. Metformin was fairly well tolerated.


CONCLUSIONS
Preliminary data suggests that metformin may safely and effectively improve the triglyceride profile. However, contrary to study hypotheses, weight, waist, and BMI reduction were not statistically significant. Future double-blind studies with larger sample sizes and of longer duration are warranted to assess more fully the safety and efficacy of this intervention.
Shin
Lauren
L
Child Psychiatry Department, Cambridge Health Alliance, Cambridge, Massachusetts, USA. lshin@challianceorg
Bregman
Hallie
H
Breeze
Janis L
JL
Noyes
Nancy
N
Frazier
Jean A
JA
D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000187:drug effects; D015430:Weight Gain / Q000187:drug effects*; D015431:Weight Loss / Q000187:drug effects
D014150:Antipsychotic Agents; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides; D008687:Metformin