The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
The National Clinical Research Center for Mental Disorders, China & Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Pharmacopsychiatry. 2019 Jan;52(1):24-31. doi: 10.1055/s-0044-101466. Epub 2018 Feb 27.
Weight gain is a common antipsychotic (AP)-related adverse drug reaction (ADR) that can increase the risk of cardiovascular diseases and premature mortality. This meta-analysis examined the efficacy and tolerability of combining metformin and lifestyle intervention for AP-related weight gain in schizophrenia.
Randomized controlled trials (RCTs) with meta-analyzable data were searched and retrieved by 2 independent investigators. RevMan software (version 5.3) was used to synthesize data, and to calculate the standardized or weighted mean differences and risk ratio with their 95% confidence intervals.
Six RCTs (n=732) were included and meta-analyzed. The metformin and lifestyle combination (MLC) group had significant reduction in weight and body mass index compared with the metformin group, lifestyle group, and placebo group. There was less frequent weight gain of≥7% in the MLC group over placebo. No other group differences in ADRs, total psychopathology, and all-cause discontinuation were found. In terms of study quality, 5 RCTs were open-labelled, 1 RCT had low risk allocation concealment, and 3 RCTs specifically described randomization methods.
Combining metformin and lifestyle intervention shows significant effect in reducing AP-related weight gain. Higher quality and larger RCTs are needed to confirm these findings.Review registration: CRD42017059198.
体重增加是一种常见的抗精神病药物（AP）相关的药物不良反应（ADR），会增加心血管疾病和过早死亡的风险。这项荟萃分析检查了二甲双胍联合生活方式干预治疗精神分裂症中与 AP 相关的体重增加的疗效和耐受性。
由 2 名独立研究员搜索和检索具有可进行荟萃分析数据的随机对照试验（RCT）。RevMan 软件（版本 5.3）用于合成数据，并计算标准化或加权均数差和风险比及其 95%置信区间。
纳入并荟萃分析了 6 项 RCT（n=732）。与二甲双胍组、生活方式组和安慰剂组相比，二甲双胍联合生活方式（MLC）组的体重和体重指数有显著下降。MLC 组体重增加≥7%的不良反应发生率低于安慰剂组。在其他不良反应、总精神病理学和全因停药方面，未发现其他组间差异。就研究质量而言，5 项 RCT 为开放性标签，1 项 RCT 分配隐藏的风险低，3 项 RCT 专门描述了随机化方法。
联合二甲双胍和生活方式干预在减少与 AP 相关的体重增加方面显示出显著效果。需要更高质量和更大规模的 RCT 来证实这些发现。
CRD42017059198。
