de Silva Varuni A, Dayabandara Madhubhashinee, Wijesundara Hiranya, Henegama Thushani, Gunewardena Heshan, Suraweera Chathurie, Hanwella Raveen
Department of Psychological Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
Department of Psychological Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
J Psychopharmacol. 2015 Dec;29(12):1255-61. doi: 10.1177/0269881115613519. Epub 2015 Oct 28.
Antipsychotic-induced weight gain causes serious health problems. We investigated the efficacy and safety of metformin in treating antipsychotic-induced weight gain in South Asian patients.
Sixty six adult patients with schizophrenia or schizoaffective disorder treated, with atypical antipsychotics, and who had increased by more than 10% their pre treatment body weight, were randomly assigned to receive metformin or placebo in a double-blind study. Patients received usual treatment and metformin 500 mg or placebo twice daily for 24 weeks. The primary outcome measure was change in body weight from baseline to week 24. Linear mixed models were used in the analysis.
Mean change in body weight in the metformin group was -1.56 kg (95% CI=-3.06 to -0.05) and 1.0 kg (95% CI=0.03-1.97) in the placebo group. Between-group difference was 2.56 kg. At 24 weeks the between-group difference showed significant time-by-treatment interaction (F=3.23, p=0.004). Between-group difference in BMI showed significant time-by-treatment interaction (F=3.41 p=0.03). There was no significant difference in waist-hip ratio or fasting blood sugar.
Metformin is effective in reducing weight in South Asian patients with schizophrenia or schizoaffective disorder who had increased their body by more than 10% after treatment with atypical antipsychotics.
抗精神病药物所致体重增加会引发严重的健康问题。我们研究了二甲双胍治疗南亚患者抗精神病药物所致体重增加的疗效和安全性。
在一项双盲研究中，将66例接受非典型抗精神病药物治疗、治疗前体重增加超过10%的成年精神分裂症或分裂情感性障碍患者随机分配接受二甲双胍或安慰剂治疗。患者接受常规治疗，二甲双胍500毫克或安慰剂每日两次，共24周。主要结局指标是从基线到第24周体重的变化。分析采用线性混合模型。
二甲双胍组体重的平均变化为-1.56千克（95%可信区间=-3.06至-0.05），安慰剂组为1.0千克（95%可信区间=0.03-至1.97）。组间差异为2.56千克。在第24周时，组间差异显示出显著的治疗时间交互作用（F=3.23，p=0.004）。体重指数的组间差异显示出显著的治疗时间交互作用（F=3.41，p=0.03）。腰臀比或空腹血糖无显著差异。
二甲双胍对于治疗后体重增加超过10%的南亚精神分裂症或分裂情感性障碍患者减轻体重有效。
