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

Research output: Contribution to journalArticle

4 Citations (Scopus)

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

LanguageEnglish
Pages24-31
Number of pages8
JournalPharmacopsychiatry
Volume52
Issue number1
DOIs
Publication statusPublished - Jan 2019

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Metformin
Antipsychotic Agents
Weight Gain
Meta-Analysis
Life Style
Randomized Controlled Trials
Placebos
Premature Mortality
Random Allocation
Drug-Related Side Effects and Adverse Reactions
Psychopathology
Weight Loss
Schizophrenia
Body Mass Index
Cardiovascular Diseases
Software
Odds Ratio
Research Personnel
Confidence Intervals

Cite this

Zheng, Wei ; Zhang, Qing E. ; Cai, Dong Bin ; Yang, Xin Hu ; Ungvari, Gabor S. ; Ng, Chee H. ; Wu, Ren Rong ; Xiang, Yu Tao. / Combination of Metformin and Lifestyle Intervention for Antipsychotic-Related Weight Gain : A Meta-Analysis of Randomized Controlled Trials. In: Pharmacopsychiatry. 2019 ; Vol. 52, No. 1. pp. 24-31.
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Combination of Metformin and Lifestyle Intervention for Antipsychotic-Related Weight Gain : A Meta-Analysis of Randomized Controlled Trials. / Zheng, Wei; Zhang, Qing E.; Cai, Dong Bin; Yang, Xin Hu; Ungvari, Gabor S.; Ng, Chee H.; Wu, Ren Rong; Xiang, Yu Tao.

In: Pharmacopsychiatry, Vol. 52, No. 1, 01.2019, p. 24-31.

Research output: Contribution to journalArticle

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