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Metformin Helps Prevent Weight Gain in Youth Taking Medication for Bipolar Disorder

Jolynn Tumolo

The type 2 diabetes drug metformin can help prevent, and in some cases reverse, weight gain in youth taking second-generation antipsychotics (SGAs) for bipolar disorder, according to short-term data from a large-scale trial presented at the recent American Academy of Child and Adolescent Psychiatry conference.

“It’s safe, effective, and very inexpensive. It’s an intervention that has the potential to have widespread applicability,” said Victor Fornari, MD, a child/adolescent psychiatrist at Northwell Health, a health care network headquartered in New Hyde Park, New York. “It’s not a medicine that you need to have an endocrinologist or a pediatrician prescribe, and I think it really speaks to the fact that the psychiatrist needs to be caring for the entire person, the physical and the mental health of the patient.”

The study enrolled 1565 patients aged 8 through 19 taking SGAs for bipolar disorder from 60 sites throughout the United States. In addition to a lifestyle intervention about healthy eating and exercise received by all participants, half were prescribed metformin.

>> READ: Evening Exercise May Ease Depressive Symptoms in Young Adults With BSD

Baseline data showed that 87% of the patients took their prescribed SGAs regularly, and a majority were unhappy and/or had felt sad, mad, or frustrated about their weight. One third had metabolic syndrome. 

According to short-term, 6-month follow-up data presented by researchers, metformin demonstrated a modest yet significant effect at preventing or reversing weight gain in participants. It did not, however, significantly affect metabolic syndrome. The only side effects reported by patients taking metformin were gastrointestinal distress symptoms.

“It’s not a drug you take and weight falls off of you, but it tends to reduce that out-of-control appetite, which we think then makes it easier for patients to adhere to a healthy diet and, as they lose some weight, maybe also make it easier for them to engage in more exercise,” said Jeffrey Welge, PhD, a professor in University of Cincinnati Department of Psychiatry and Behavioral Neuroscience, Cincinnati, Ohio. “So, the lifestyle is really what’s driving good outcomes, but metformin is in some cases putting the wind at their back to help with that.”

Reference

Study: metformin can help youth manage weight gain side effect of bipolar medications. News release. University of Cincinnati; October 27, 2023. Accessed November 10, 2023.