Double-blind, randomized, clinical trial of metformin as add-on treatment with
clozapine in treatment of schizophrenia disorder.
Author(s): Hebrani P(1), Manteghi AA(1), Behdani F(1), Hessami E(1), Rezayat KA(2), Marvast
MN(1), Rezayat AA(3).
Affiliation(s): Author information:
(1)Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran. (2)Department of Internal Medicine, Faculty of Medicine,
Mashhad University of Medical Sciences, Mashhad, Iran. (3)Student Research
Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad,
Iran.
Publication date & source: 2015, J Res Med Sci. , 20(4):364-71
BACKGROUND: One of the major causes of death in schizophrenia is a metabolic
syndrome. The clozapine has the highest rate of weight gain among antipsychotics.
It has been shown that metformin can promote weight loss. We aimed to investigate
the effect of metformin as an adjunctive therapy with clozapine to prevent
metabolic syndrome in patients with schizophrenia.
MATERIALS AND METHODS: A total of 37 patients consisting metformin group (19
cases) and a group of placebo consisting of 18 cases were evaluated. A brief
psychiatric rating scale score (BPRS) and metabolic profiles was determined for
all patients. All of the variables were also determined at 2, 8, 16, and 20 weeks
after the onset of the study.
RESULTS: The mean age of the group of metformin was 47.2 ± 10.4 compared with
45.8 ± 10.2 for the group of placebo. The difference in mean waist circumference
and serum level of triglyceride at baseline compared with the end of study showed
a statistically significant difference between two groups (P = 0. 000). A
statistically significant difference was also observed in a comparison of mean
difference of weight and body mass index at baseline compared with end of study
(P = 0. 000). There was a statistically significant difference of fasting blood
sugar (P = 0.011) and serum high-density lipoprotein (P = 0.000) between two
groups but this difference was not significant for mean BPRS scores, mean
systolic and diastolic blood pressure, serum level of triiodothyronine, thyroxin
and thyroid stimulating hormone, serum low-density lipoprotein and serum
cholesterol.
CONCLUSION: Metformin could be considered an adjunctive therapy with clozapine to
prevent metabolic syndrome in schizophrenic patients.
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