Jesus Cátia, Jesus Inês, Agius Mark
Charles University in Prague, Third Faculty of Medicine, Prague, Czech Republic,
Psychiatr Danub. 2015 Sep;27 Suppl 1:S489-91.
Psychiatric patients requiring therapy with antipsychotics have a greater incidence of becoming overweight or obese compared with the general population. Many of these patients are often treated with second-generation (atypical) antipsychotics (SGAs), which are associated with weight gain, dyslipidaemia, and other metabolic derangements. The most important and first line of treatment for the metabolic syndrome is lifestyle changes including diet and exercise. However, other approaches like the use of medication (e.g. Metformin) have been also used, mainly when the lifestyle changes are difficult to achieve. Therefore, the treatment of antipsychotic-induced weight gain with metformin may be an option after the lifestyle and dietary changes fail. The use of metformin is still experimental and off license regarding the treatment of metabolic syndrome in Psychiatric patients, however we wished to assess the evidence for its use.
Our study is a literature based research. For our research we reviewed 12 Pubmed published articles from 2006 to 2013.
Metformin have been reported to counteract effectively antipsychotic-induced body weight gain and has been demonstrated to improve glycaemic control and promote a moderate weight loss in both diabetic and non-diabetic subjects. Metformin use appears to be a benefit when started early in the course of treatment and mostly in young adults newly exposed to antipsychotic drugs.
与普通人群相比,需要使用抗精神病药物进行治疗的精神病患者超重或肥胖的发生率更高。这些患者中的许多人经常接受第二代(非典型)抗精神病药物(SGA)治疗,这些药物与体重增加、血脂异常及其他代谢紊乱有关。代谢综合征最重要的一线治疗方法是生活方式改变,包括饮食和运动。然而,也使用了其他方法,如使用药物(如二甲双胍),主要是在难以实现生活方式改变时。因此,在生活方式和饮食改变失败后,用二甲双胍治疗抗精神病药物引起的体重增加可能是一种选择。关于二甲双胍在精神病患者代谢综合征治疗中的应用仍处于实验阶段且未获得许可,然而我们希望评估其使用的证据。
我们的研究是一项基于文献的研究。为了我们的研究,我们查阅了2006年至2013年发表在PubMed上的12篇文章。
据报道,二甲双胍可有效对抗抗精神病药物引起的体重增加,并且已证明在糖尿病和非糖尿病患者中均可改善血糖控制并促进适度体重减轻。在治疗过程早期开始使用二甲双胍似乎有益,且主要适用于新接触抗精神病药物的年轻成年人。