Chen Chun-Hsin, Chiu Chih-Chiang, Huang Ming-Chyi, Wu Tzu-Hua, Liu Hui-Ching, Lu Mong-Liang
Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Prog Neuropsychopharmacol Biol Psychiatry. 2008 May 15;32(4):925-31. doi: 10.1016/j.pnpbp.2007.11.013. Epub 2007 Nov 17.
The second generation antipsychotic drugs, such as risperidone, olanzapine, and quetiapine, are effective in treating patients with schizophrenia and have been considered as the first line therapy. Recently, increasing attention has been drawn to the potential diabetogenic effect of these novel antipsychotics. The goal of this study was to evaluate the effect of metformin treatment on the olanzapine-induced metabolic disturbance in schizophrenic patients. Twenty-four schizophrenic subjects who had received olanzapine treatment at least 3 months were assigned to the therapy with metformin 1500 mg/day for 8 weeks. The metabolic parameters were quantitatively assessed at baseline, weeks 2, 4, and 8 by using the intravenous glucose tolerance test. After an 8-week treatment with metformin, the body weight, fasting levels of glucose, triglyceride, and insulin, insulin secretion, and insulin resistance significantly decreased. Half of study subjects with metabolic syndrome obtained improvement after the metformin trial. Subjects' psychopathological condition remained unchanged during the study period. The olanzapine-induced metabolic disturbance could be reversed after 8-week metformin treatment. Based on the results of this study, we hypothesize that metformin could modulate the effect of olanzapine-induced metabolic disturbance.
第二代抗精神病药物，如利培酮、奥氮平和喹硫平，在治疗精神分裂症患者方面有效，并被视为一线治疗药物。最近，这些新型抗精神病药物潜在的致糖尿病作用受到了越来越多的关注。本研究的目的是评估二甲双胍治疗对奥氮平引起的精神分裂症患者代谢紊乱的影响。24名接受奥氮平治疗至少3个月的精神分裂症患者被分配接受每天1500毫克二甲双胍的治疗，为期8周。在基线、第2周、第4周和第8周通过静脉葡萄糖耐量试验对代谢参数进行定量评估。经过8周的二甲双胍治疗后，体重、空腹血糖、甘油三酯和胰岛素水平、胰岛素分泌以及胰岛素抵抗均显著下降。一半患有代谢综合征的研究对象在二甲双胍试验后病情得到改善。在研究期间，受试者的精神病理状况保持不变。奥氮平引起的代谢紊乱在接受8周二甲双胍治疗后可以得到逆转。基于本研究结果，我们推测二甲双胍可以调节奥氮平引起的代谢紊乱的作用。
