Details

Autor(en) / Beteiligte

• Knezevic, Vladimir
• Abazovic, Minja
• Dickov, Aleksandra
• Ratkovic, Dragana
• Comic, Masa
• Savic, Predrag

Titel

ADJUNCTIVE USE OF METFORMIN IN THE TREATMENT OF ATYPICAL ANTIPSYCHOTIC-INDUCED WEIGHT GAIN/ADJUVANTNA PRIMENA METFORMINA ZA TRETMAN POVECANJA TELESNE TEZINE NASTAO ZBOG KORISCENJA ATIPICNIH ANTIPSIHOTIKA

Ist Teil von

• Medicinski pregled, 2022-05, Vol.75 (5-6), p.151

Ort / Verlag

Drustvo Lekara Vojvodine

Erscheinungsjahr

2022

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Introduction. Atypical antipsychotics are the gold standard in the treatment of psychotic and other mental disorders due to their efficacy and tolerability. However, the relatively frequent occurrence of antipsychotic-induced metabolic syndrome has encouraged research into possible solutions to this problem, including the adjunctive use of metformin. The aim of this review article is to present a concise, comprehensive and critical overview of the aforementioned issue based on the analysis of available experimental research. Material and Methods. PubMed and Google Scholar databases were searched for relevant literature published in a fifteen-year period between 2008 and 2022. The following terms were used in the search: atypical antipsychotics, metformin, and weight gain. Only double-blind, placebo-controlled, randomized, and cohort studies were taken into consideration. Results. A total of 145 papers were analyzed, of which 10 papers with 852 subjects met the inclusion criteria. All the reviewed studies concluded that the adjunctive administration of metformin at a daily dose of 500 mg to 2,000 mg has significantly reduced atypical antipsychotic-induced weight gain, with a favorable effect on other metabolic parameters that were examined in the analyzed papers. Conclusion. Taking into account the increased cardiovascular morbidity and the consequent mortality among those who have been using atypical antipsychotics in the long term, it is necessary to assess the risks and benefits of introducing adjunctive metformin in every patient who is at risk of developing metabolic syndrome. In order to recommend the routine use of metformin in such indications, studies that would include a larger sample and a longer period of treatment are needed. Key words: Antipsychotic Agents; Schizophrenia; Metformin; Body Weight; Metabolic Syndrome; Metabolic Side Effects of Drugs and Substances; Olanzapine Uvod. Atipicni antipsihotici predstavljaju zlatni standard u lecenju psihoticnih i drugih mentalnih poremecaja zbog svoje efikasnosti i podnosljivosti. Medutim, relativno cesta pojava metabolickog sindroma indukovanog antipsihoticima je podstakla istrazivanja o mogucim resenjima ovog problema, ukljucujuci i adjuvantnu primenu metformina. Cilj ovog preglednog clanka je da predstavi koncizan, sveobuhvatan i kriticki prikaz navedene problematike na osnovu analize dostupnih eksperimentalnih istrazivanja. Materijal i metode. Za pretragu literature su koriscene Pubmed i Google scholar baze podataka za petnaestogodisnji period od 2008. do 2022. godine. Termini koji su korisceni prilikom pretrage su: atipicni antipsihotici, metformin i povecanje telesne tezine. Razmatrane su iskljucivo dvostruko slepe, placebo kontrolisane, randomizovane i kohortne studije. Rezultati. Analizirano je ukupno 145 radova od kojih je 10 radova sa 852 ispitanika odgovaralo kriterijumima za ukljucivanje. Utvrdeno je da je adjuvantna primena metformina u dnevnoj dozi od 500 mg do 2.000 mg kod osoba kod kojih je zbog koriscenja atipicnih antipsihotika doslo do povecanja telesne mase u svim istrazivanjima dovela do redukcije telesne mase, uz povoljan uticaj i na druge metabolicke parametre koji su ispitivani u pojedinim istrazivanjima. Zakljucak. Uzimajuci u obzir povecan morbiditet od kardiovaskularnih oboljenja i konsekventni morbiditet u populaciji osoba koje dugorocno koriste atipicne antipsihotike potrebno je kod svakog pacijenta koji je pod rizikom od pojave metabolickog sindroma proceniti potrebu za uvodenjem adjuvantnog metformina. Za preporuku rutinske upotrebe metformina za navedenu indikaciju potrebne su studije koje bi obuhvatile veci uzorak i duzi vremenski period lecenja. Kljucne reci: antipsihoticki agensi; sizofrenija; metformin; telesna tezina; metabolicki sindrom; metabolicki poremecaji izazvani lekovima; olanzapin