Department of Psychiatry, Western Regional Integrated Health Authority, Sir Thomas Roddick Hospital, Stephenville, Newfoundland, Canada.
CNS Drugs. 2010 Mar;24(3):193-206. doi: 10.2165/11530130-000000000-00000.
Individuals receiving certain atypical antipsychotic medications are at risk of gaining weight and developing metabolic problems. There are no established drug treatments to prevent or counter these problems. However, the antihyperglycaemic agent metformin appears promising in some recent studies and we review the literature that evaluates metformin for limiting or reversing atypical antipsychotic drug-induced weight gain and glucose metabolism dysregulation. These studies suggest that metformin is beneficial if started early in antipsychotic drug treatment. Metformin has also been shown to prevent or delay the onset of type 2 diabetes mellitus in high-risk individuals from the general population. Based on these findings, we identify antipsychotic drug-treated patients who might benefit from metformin therapy and offer clinical guidelines for its use. Further long-term studies are needed to extend our observations and improve this strategy.
接受某些非典型抗精神病药物治疗的个体有体重增加和出现代谢问题的风险。目前尚无既定的药物治疗方法来预防或对抗这些问题。然而，在一些最近的研究中，抗高血糖药物二甲双胍似乎很有前景，我们回顾了评估二甲双胍限制或逆转非典型抗精神病药物引起的体重增加和葡萄糖代谢紊乱的文献。这些研究表明，如果在抗精神病药物治疗早期开始使用二甲双胍，那么它是有益的。二甲双胍还被证明可以预防或延迟普通人群中高危个体的 2 型糖尿病的发病。基于这些发现，我们确定了可能从二甲双胍治疗中获益的抗精神病药物治疗患者，并提供了其使用的临床指南。需要进一步的长期研究来扩展我们的观察结果并改进这一策略。
