AlHussain Fatimah, AlRuthia Yazed, Al-Mandeel Hazem, Bellahwal Arwa, Alharbi Fadia, Almogbel Yasser, Awwad Oriana, Dala'een Roua, Alharbi Fawaz Abdullah
Department of Pharmacoeconomics and Drug Pricing, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.
Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Patient Prefer Adherence. 2020 Apr 15;14:737-746. doi: 10.2147/PPA.S244273. eCollection 2020.
Metformin is commonly prescribed to manage polycystic ovary syndrome (PCOS), which is one of the most common endocrine disorders among women of childbearing age and is associated with high prevalence rates of depression and anxiety.
This study's objective was to determine the impact of prescribed metformin on depression and anxiety levels of patients with PCOS.
This prospective, multi-center, cohort study examined the impact of prescribed metformin on the depression and anxiety of women with PCOS in four gynecology clinics in Saudi Arabia and Jordan. The women had recently been prescribed metformin along with lifestyle modifications, such as diet and exercise, and were compared to another group of women with PCOS who were prescribed lifestyle modifications only. Depression and anxiety were assessed at baseline and three months later using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scale, respectively. Health-related quality of life was measured using the Short Form Health Survey (SF-36). Multiple logistic regression analyses were conducted to examine the impact of metformin on depression and anxiety.
Eighty-six women participated in the study: 53 were prescribed metformin with lifestyle modifications, and 33 were prescribed lifestyle modifications only. The women on metformin had 70% lower odds of having major depression (PHQ-9≥10) (OR=0.302, =0.045); however, no significant effect of metformin on anxiety (GAD-7≥10) was found.
Metformin may have a role in the management of depression symptoms among patients with PCOS; however, its potential antidepressant effect should be further examined in randomized double-blind placebo-controlled clinical trials.
二甲双胍常用于治疗多囊卵巢综合征（PCOS），这是育龄女性中最常见的内分泌疾病之一，且与抑郁症和焦虑症的高患病率相关。
本研究的目的是确定处方二甲双胍对PCOS患者抑郁和焦虑水平的影响。
这项前瞻性、多中心队列研究考察了沙特阿拉伯和约旦的四家妇科诊所中，处方二甲双胍对PCOS女性抑郁和焦虑的影响。这些女性最近开始服用二甲双胍并配合生活方式的改变，如饮食和运动，并与另一组仅接受生活方式改变治疗的PCOS女性进行比较。分别在基线和三个月后使用患者健康问卷（PHQ - 9）和广泛性焦虑障碍（GAD - 7）量表评估抑郁和焦虑情况。使用简短健康调查问卷（SF - 36）测量健康相关生活质量。进行多项逻辑回归分析以考察二甲双胍对抑郁和焦虑的影响。
86名女性参与了该研究：53名女性被处方二甲双胍并配合生活方式改变，33名女性仅被处方生活方式改变。服用二甲双胍的女性患重度抑郁症（PHQ - 9≥10）的几率降低了70%（OR = 0.302， = 0.045）；然而，未发现二甲双胍对焦虑（GAD - 7≥10）有显著影响。
二甲双胍可能在PCOS患者的抑郁症状管理中发挥作用；然而，其潜在的抗抑郁作用应在随机双盲安慰剂对照临床试验中进一步研究。
