Efficacy and safety of metformin as adjunctive treatment of metabolic syndrome caused by second generation antipsychotic (SGAs) in schizophrenia patients
Keywords:
metabolic syndrome, metformin, second generation antipsychotic, schizophreniaAbstract
Objective: To evaluate the effectiveness and safety of metformin as an adjunctive treatment of metabolic syndrome in schizophrenia patients using second-generation antipsychotics (SGAs).
Method: This was a six months open-labelled, randomized, prospective trial at Nakhon Sawan Rajanagarindra Psychiatric Hospital. Fifty schizophrenia patients aged between 18 and 45 who were diagnosed with metabolic syndrome after receiving SGAs were selected and randomized into two groups with the control group received treatment- as- usual, while the experimental group receiving adjunctive treatment of 1000 mg of metformin daily. The metabolic parameters as well as blood chemistry, self-reported of side effects and drug compliance were measured at baseline, one, three and six months.
Result: There were statistically significant reductions in fasting blood sugar (FBS) in the experimental group at all points of the evaluation compared to the control group. At the end of 6 months, the experimental group showed a significant reduction in waist circumference and an increase in high-density lipoprotein more than the control group. No significant change in blood pressure nor triglyceride were recorded. Abdominal discomfort, nausea/vomiting, and drowsiness were the most common side effects reported in the first month and abated on their own. In some participants, the liver enzymes were slightly higher than average, with no clinical symptoms, and 76.2% were tolerant and had good adherence.
Conclusion: Metformin is effective and safe. It is a possible alternative therapy for the treatment of metabolic disorders in schizophrenic patients taking newer antipsychotic drugs.
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