6ER-010 Metformin for prevention and treatment of antipsychotic induced weight gain

<h3>Background and Importance</h3> Weight gain and metabolic complications are substantial adverse effects associated with second-generation antipsychotics. However, comprehensive guidelines for managing antipsychotic induced weight gain are lacking. <h3>Aim and Objectives</h3> This study determined the most appropriate dosage and duration of metformin treatment to prevent and manage antipsychotic induced weight gain. The findings of this study can provide valuable guidance for medical experts. <h3>Material and Methods</h3> This review included all double-blind, placebo-controlled studies investigating metformin’s effectiveness in addressing antipsychotic-related weight gain. We systematically searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, Google Scholar, and ClinicalTrials.gov for relevant studies from the inception to 2024. A random effects model was used for the meta-analysis. <h3>Results</h3> This meta-analysis including 20 studies with 1,070 patients revealed that metformin significantly surpassed placebo in attenuating weight gain in patients receiving antipsychotics. The mean weight change with metformin was −3.32 kg (95% confidence interval (CI): −4.57 to −2.07). Additionally, metformin use resulted in a noticeable decrease in body mass index (−1.24 kg/m² (95% CI: −1.70 to −0.77)). No significant differences were observed in outcomes between treatment durations of 12 and 24 weeks. Furthermore, the efficacy of metformin was not significantly different between doses of ≤1000 mg and &gt;1000 mg. <h3>Conclusion and Relevance</h3> This updated meta-analysis investigated the durations, dosages of metformin use in patients with schizophrenia experiencing antipsychotic induced weight gain. The findings highlight the need for additional large-scale research to validate our findings. <h3>References and/or Acknowledgements</h3> Reference de Silva, VA, <i>et al</i>. Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and meta-analysis<i>. BMC Psychiatry</i>, 2016;<b>16</b>(1):341. <h3>Conflict of Interest</h3> No conflict of interest