title: Metformin for weight loss and metabolic control in overweight outpatients with schizophrenia and schizoaffective disorder.
abstract: OBJECTIVE
  The purpose of this study was to determine whether metformin promotes weight loss in overweight outpatients with chronic schizophrenia or schizoaffective disorder.
  
  
  METHODS
  In a double-blind study, 148 clinically stable, overweight (body mass index [BMI] ≥27) outpatients with chronic schizophrenia or schizoaffective disorder were randomly assigned to receive 16 weeks of metformin or placebo. Metformin was titrated up to 1,000 mg twice daily, as tolerated. All patients continued to receive their prestudy medications, and all received weekly diet and exercise counseling. The primary outcome measure was change in body weight from baseline to week 16.
  
  
  RESULTS
  Fifty-eight (77.3%) patients who received metformin and 58 (81.7%) who received placebo completed 16 weeks of treatment. Mean change in body weight was -3.0 kg (95% CI=-4.0 to -2.0) for the metformin group and -1.0 kg (95% CI=-2.0 to 0.0) for the placebo group, with a between-group difference of -2.0 kg (95% CI=-3.4 to -0.6). Metformin also demonstrated a significant between-group advantage for BMI (-0.7; 95% CI=-1.1 to -0.2), triglyceride level (-20.2 mg/dL; 95% CI=-39.2 to -1.3), and hemoglobin A1c level (-0.07%; 95% CI=-0.14 to -0.004). Metformin-associated side effects were mostly gastrointestinal and generally transient, and they rarely led to treatment discontinuation.
  
  
  CONCLUSIONS
  Metformin was modestly effective in reducing weight and other risk factors for cardiovascular disease in clinically stable, overweight outpatients with chronic schizophrenia or schizoaffective disorder over 16 weeks. A significant time-by-treatment interaction suggests that benefits of metformin may continue to accrue with longer treatment. Metformin may have an important role in diminishing the adverse consequences of obesity and metabolic impairments in patients with schizophrenia.
authors.forename: L Fredrik
authors.initials: LF
authors.lastname: Jarskog
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hamer
authors.forename: Diane J
authors.initials: DJ
authors.lastname: Catellier
authors.forename: Dawn D
authors.initials: DD
authors.lastname: Stewart
authors.forename: Lisa
authors.initials: L
authors.lastname: Lavange
authors.forename: Neepa
authors.initials: N
authors.lastname: Ray
authors.forename: Lauren H
authors.initials: LH
authors.lastname: Golden
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lieberman
authors.forename: T Scott
authors.initials: TS
authors.lastname: Stroup
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015992:Body Mass Index; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008659:Metabolic Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008687:Metformin / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D014150:Antipsychotic Agents; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin