Metformin as an adjunctive treatment to control body weight and metabolic dysfunction during olanzapine administration:: A multicentric, double-blind, placebo-controlled trial

被引:108
作者
Baptista, Trino
Rangel, Nairy
Fernandez, Virginia
Carrizo, Edgardo
El Fakih, Yarnily
Uzcategui, Euderruh
Galeazzi, Tatiana
Gutierrez, Maria A.
Servigna, Mercedes
Davila, Adriana
Uzcategui, Marycelvia
Serrano, Ana
Connell, Lisette
Beaulieu, Serge
de Baptista, Enma Araujo
机构
[1] Univ Los Andes, Sch Med, Dept Physiol, Merida 5101 A, Venezuela
[2] Psychiat Inst Dr Raul Castillo, San Cristobal, Tachira State, Venezuela
[3] Univ Zulia, Sch Med, Inst Clin Res Dr Amer Negrette, Maracaibo 4011, Venezuela
[4] Univ Los Andes, Sch Med, Dept Psychiat, Merida, Venezuela
[5] Univ Los Andes, Sch Med, Dept Microbiol, Sch Pharm, Merida, Venezuela
[6] Univ Los Andes, Sch Med, LABIMET, San Cristobal, Venezuela
[7] CATESFAM, Maracaibo, Venezuela
[8] McGill Univ, Douglas Hosp, Res Ctr, Montreal, PQ, Canada
关键词
antidiabetic agents; atypical antipsychotics; obesity; diabetes; dyslipidemia; endothelial dysfunction; POLYCYSTIC-OVARY-SYNDROME; INSULIN-RESISTANCE ATHEROSCLEROSIS; LIFE-STYLE MODIFICATION; ANTIPSYCHOTIC-DRUGS; GLUCOSE-TOLERANCE; RISK-FACTORS; GAIN; WOMEN; PREVENTION; DIET;
D O I
10.1016/j.schres.2007.03.029
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background: Excessive body weight gain (BWG) is a clinically relevant side effect of olanzapine administration. The primary objective of this study was to assess whether metformin prevents or reverses BWG in patients with schizophrenia or bipolar disorder under olanzapine administration. Secondarily we evaluated diverse metabolic variables. Methods: Eighty patients taking olanzapine (5-20 mg daily for more than 4 consecutive months) were randomly allocated to metformin (n = 40; 850 to 2550 mg daily) or placebo (n = 40) group in a 12-week double-blind protocol. Waist circumference (WC) body weight (BW), body mass index (BMI) fasting glucose, glycated hemoglobin (Hblc), insulin, an insulin resistance index (HOMA-IR) lipids, leptin, c-reactive protein, fibrinogen, cortisol and the growth hormone (GH) were evaluated at baseline and at week 12 of treatment. Results: The metformin group lost 1.4 +/- 3.2 kg (p = 0.01) and tended to decrease its leptin levels, whereas the placebo group maintained a stable weight: -0.18 +/- 2.8 kg (p = 0.7). The HOMA-IR significantly increased after placebo (p = 0.006) and did not change after metformin (p = 0.8). No ostensible differences were observed in the other variables, even though metformin did not improve the lipid profile and the Hblc levels. Conclusions: Metformin may safely assist olanzapine-treated patients in body weight and carbohydrate metabolism control. (c) 2007 Elsevier B.V. All rights reserved.
引用
收藏
页码:99 / 108
页数:10
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