title: Double-blind, randomized, clinical trial of metformin as add-on treatment with clozapine in treatment of schizophrenia disorder.
abstract: BACKGROUND
  One of the major causes of death in schizophrenia is a metabolic syndrome. The clozapine has the highest rate of weight gain among antipsychotics. It has been shown that metformin can promote weight loss. We aimed to investigate the effect of metformin as an adjunctive therapy with clozapine to prevent metabolic syndrome in patients with schizophrenia.
  
  
  METHODS
  A total of 37 patients consisting metformin group (19 cases) and a group of placebo consisting of 18 cases were evaluated. A brief psychiatric rating scale score (BPRS) and metabolic profiles was determined for all patients. All of the variables were also determined at 2, 8, 16, and 20 weeks after the onset of the study.
  
  
  RESULTS
  The mean age of the group of metformin was 47.2 ± 10.4 compared with 45.8 ± 10.2 for the group of placebo. The difference in mean waist circumference and serum level of triglyceride at baseline compared with the end of study showed a statistically significant difference between two groups (P = 0. 000). A statistically significant difference was also observed in a comparison of mean difference of weight and body mass index at baseline compared with end of study (P = 0. 000). There was a statistically significant difference of fasting blood sugar (P = 0.011) and serum high-density lipoprotein (P = 0.000) between two groups but this difference was not significant for mean BPRS scores, mean systolic and diastolic blood pressure, serum level of triiodothyronine, thyroxin and thyroid stimulating hormone, serum low-density lipoprotein and serum cholesterol.
  
  
  CONCLUSIONS
  Metformin could be considered an adjunctive therapy with clozapine to prevent metabolic syndrome in schizophrenic patients.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Paria
authors.initials: P
authors.lastname: Hebrani
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali Akhoundpour
authors.initials: AA
authors.lastname: Manteghi
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Behdani
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Hessami
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Kambiz Akhavan
authors.initials: KA
authors.lastname: Rezayat
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Majid Nabizadeh
authors.initials: MN
authors.lastname: Marvast
authors.affiliation: Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Amir Akhavan
authors.initials: AA
authors.lastname: Rezayat
keywords: Clozapine; metformin; schizophrenia