Friday, January 29, 2016

Metformin May Normalize Antipsychotic-Induced Lipid Imbalance in People With Schizophrenia

Patients with schizophrenia who take antipsychotics commonly experience serious adverse metabolic effects including dyslipidemia—a condition characterized by abnormally high levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides, as well as abnormally low levels of high-density lipoprotein cholesterol (HDL-C). A study published this week in Molecular Psychiatry now suggests that the type 2 diabetes medication metformin may be able to help normalize lipid levels in this patient population.

Although there is evidence to suggest metformin decreases triglycerides and LDL-C in patients with diabetes, it was unknown whether the medication would offer similar benefits to schizophrenia patients with antipsychotic-induced dyslipidemia who have weight gain and/or have developed insulin resistance after antipsychotic treatment.

A team of researchers from the United States and China pooled data from two randomized, placebo-controlled trials, including 201 schizophrenia patients aged 18 to 40 who had experienced dyslipidemia within the first year of being treated with one of four antipsychotics: clozapine, olanzapine, risperidone, or sulpiride. The patients were randomly assigned to take 500 mg of metformin or placebo twice a day for six months. (Participants who were taking an antipsychotic at the time of trial start remained on the medication until the trial’s completion.)

After 24 weeks of treatment, 25.3% of patients in the metformin group had dyslipidemia (defined by LDL-C greater than or equal to 3.37 mmol/L) compared with 64.8% in the placebo group. In contrast, 54.2% of the patients in the placebo group who had a normal LDL-C levels at baseline developed dyslipidemia over the course of the trial compared with 14.3% taking metformin.

“Metformin treatment had [a] significant effect on not only controlling weight gain, insulin, and insulin resistance, … but also significantly improving the altered level of lipids, including LDL-C, HDL-C, total cholesterol, and triglycerides in blood,” the authors wrote. The findings suggest “that the addition of metformin to antipsychotics is a potential treatment to attenuate dyslipidemia in patients with schizophrenia,” they concluded.

For related information, see the Psychiatric News article “Coding for Coverage for Lipid Testing.”

(Image: CLIPAREA l Custom media/Shutterstock)


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