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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.”
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