CoHP - SoP - Student Works

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Browsing CoHP - SoP - Student Works by Author "Bosquet, Randy"

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    METFORMIN REDUCES ATYPICAL ANTIPSYCHOTIC-ASSOCIATED WEIGHT GAIN IN ADULTS
    (2023-04-20) Bosquet, Randy; Caron, Lindsey; James, Shannon
    Purpose: Metformin is an underutilized management strategy in preventing and treating antipsychotic-associated weight gain (AAWG). Pharmacists may be in a unique position to educate providers and drive implementation into current clinical practice. This review analyzes recent literature to identify the impact of metformin treatment on AAWG in adult patients. Methods: We performed a review using PubMed with search criteria (antipsychotic induced weight gain) AND (metformin) which yielded 125 results. Articles were included if they discussed AAWG for adult patients along with metformin use for prophylaxis or treatment. Articles were excluded if they focused on the pediatric population or did not include management strategies for AAWG. There were 21 studies that were analyzed and included in this review. The primary endpoint was weight loss or change in weight in patients taking metformin with an atypical antipsychotic. Results: Although AAWG is common amongst all medications within the class, studies showed that some atypical antipsychotics have a much larger incidence rate without metformin use, such as olanzapine, where 30% of individuals were shown to have greater than 7% increase in body weight from baseline. Both short and long-term studies show metformin prevents an increase in weight gain by about 5 kg when it is started at the initiation of an atypical antipsychotic. Treatment based metformin use showed an approximate 3 kg reduction in body weight when started after AAWG occurred. Studies showed that higher doses of metformin (>500 mg) had a greater effect on weight decrease when compared to other dosages. Doses of metformin ranged from 500 to 2250 mg daily for AAWG prophylaxis and treatment ranged from 6 weeks to 18 months long. Conclusion: Use of metformin prophylactically could decrease premature discontinuation of atypical antipsychotics and prevent associated morbidity. Future studies could assess the impact of pharmacist led metformin protocols in patients initiating atypical antipsychotics.