Combination of Metformin and Lifestyle Intervention for Antipsychotic-Related Weight Gain: A Meta-Analysis of Randomized Controlled Trials

Wei Zheng; Qing-E Zhang; Dong-Bin Cai; Xin-Hu Yang; Gabor S. Ungvari; Chee H. Ng; Ren-Rong Wu; Yu-Tao Xiang

doi:10.1055/s-0044-101466

Pharmacopsychiatry, Inhaltsverzeichnis

Pharmacopsychiatry 2019; 52(01): 24-31
DOI: 10.1055/s-0044-101466

Original Paper

Combination of Metformin and Lifestyle Intervention for Antipsychotic-Related Weight Gain: A Meta-Analysis of Randomized Controlled Trials

Wei Zheng^*

¹The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China

,

Qing-E Zhang^*

²The 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

,

Dong-Bin Cai

³Clinics of Chinese Medicine, First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China

,

Xin-Hu Yang

¹The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China

,

Gabor S. Ungvari

⁴The University of Notre Dame Australia / Graylands Hospital, Perth, Australia

,

Chee H. Ng

⁵Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia

,

Ren-Rong Wu

⁶Mental Health Institute of the Second Xiangya Hospital & National Technology Institute of Psychiatry & Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China

,

Yu-Tao Xiang

⁷Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China

› Institutsangaben

Abstract

Introduction 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.

Methods 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.

Results 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.

Conclusion 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

Key words

metformin - lifestyle - weight gain - schizophrenia - meta-analysis

Volltext

Referenzen

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