Metformin for Treatment of Overweight Induced by Atypical Antipsychotic Medication in Young People With Autism Spectrum Disorder

Anagnostou, Evdokia; Aman, Michael G.; Handen, Benjamin L.; Sanders, Kevin; Shui, Amy; Hollway, Jill A.; Brian, Jessica; Arnold, L. Eugene; Capano, Lucia; Hellings, Jessica A.; Butter, Eric; Mankad, Deepali; Tumuluru, Rameshwari V.; Kettel, Jessica; Newsom, Cassandra R.; Hadjiyannakis, Stasia; Peleg, Naomi; Odrobina, Dina; McAuliffe-Bellin, Sarah; Zakroysky, Pearl; Marler, Sarah; Wagner, Alexis; Wong, Taylor; Macklin, Eric A.; Veenstra‐VanderWeele, Jeremy

doi:10.1001/jamapsychiatry.2016.1232

Cited by 102 publications

(80 citation statements)

References 40 publications

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“…A recent meta-analysis of adults has indirectly demonstrated that the amount of weight loss due to lifestyle interventions may be similar to that provided by use of pharmaceutical agents (9). Though contradictory findings exist, including a study (10) in which medication alone was more effective for weight loss than behavioral interventions, it is possible that this study reflects the difficulty of many psychiatric patients to adhere to strict dietary guidelines or exercise regimens, including those used in behavioral interventions (10, 11). This is one reason that medications like metformin are being studied.…”

Section: Evidence For Lifestyle Interventions For Weight Lossmentioning

confidence: 93%

“…Multiple mechanisms have been proposed for its effect on weight loss. These include its ability to decrease insulin resistance (reversing the insulin resistance caused by antipsychotics) and reduce hepatic glucose production (11, 12). While multiple RCTs and meta-analyses show metformin to be moderately beneficial for promoting weight loss in adults using antipsychotics, others found no weight loss benefits (13–15).…”

Section: Metformin As a Medication For Weight Lossmentioning

confidence: 99%

“…Metformin’s efficacy in treating antipsychotic-induced weight gain in youth has been examined in open label trials and case reports (14, 17). However, only three RCTs examining its efficacy in treating antipsychotic-induced weight gain in children have been published (1, 11, 18). …”

Section: Metformin As a Medication For Weight Lossmentioning

confidence: 99%

“…Anagnostou et al (11) subsequently examined the impact of metformin on weight reduction in 61 children (ages 6–17) with autism spectrum disorder taking various SGAs. This study found that metformin was more effective than placebo in treating antipsychotic-induced weight gain.…”

Section: Subsequent Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Commentary: A Randomized, Double-Blind, Placebo-Controlled Trial of Metformin Treatment of Weight Gain Associated with Initiation of Atypical Antipsychotic Therapy in Children and Adolescents

Goltz

Rice

2017

Front. Psychiatry

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Section: Evidence For Lifestyle Interventions For Weight Lossmentioning

confidence: 93%

Section: Metformin As a Medication For Weight Lossmentioning

confidence: 99%

Section: Metformin As a Medication For Weight Lossmentioning

confidence: 99%

Section: Subsequent Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Commentary: A Randomized, Double-Blind, Placebo-Controlled Trial of Metformin Treatment of Weight Gain Associated with Initiation of Atypical Antipsychotic Therapy in Children and Adolescents

Goltz

Rice

2017

Front. Psychiatry

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“…Whereas most of the studies reviewed in earlier sections reported that metformin was well tolerated, 1 study 14 reported significantly more adverse events with metformin; the commonest adverse event was gastrointestinal disturbance, something that is well known. The use of an extended-release formulation may improve the tolerability of the drug.…”

Section: Safety and Tolerabilitymentioning

confidence: 97%

Metformin as a Possible Intervention for Cardiometabolic Risks in Pediatric Subjects Exposed to Antipsychotic Drugs

Andrade

2016

J. Clin. Psychiatry

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Evaluation and Management of Self-injury in a Child With a Rare Genomic Variant

et al. 2018

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A 4-year-old boy was referred to the child psychiatry clinic for management of tantrums with aggression and self-injurious behavior. Tantrums were unpredictable and often resulted in severe head-butting. His parents also reported atypical social and language development, disrupted sleep, and persistent impulsivity with attempts to elope.The patient had a complex medical history that was marked by prematurity at 32 weeks, slow postnatal growth, and severe gastroesophageal reflux. Genetic testing following an episode of hypoglycemia revealed microdeletion of the 16p11.2 region of chromosome 16. His pediatrician documented a normal neurological examination without dysmorphology or congenital anomalies.A developmental evaluation revealed delays in motor function and language development notable by age 2 years. He attended a 0 to 3 program with intensive speech therapy and then moved to a self-contained preschool classroom with a 1:1 staff-to-student ratio. He received school-based speech, occupational, and physical therapies. Testing results revealed clinically significant scores on the Autism Diagnostic Observation Schedule. Cognitive testing results showed that his IQ was below average but was likely an underestimate due to noncompliance. The parents stated that he played repetitively, lining up toy cars and spinning their wheels. He did not seek or give comfort to others when distressed. He had tactile hypersensitivity but pain hyposensitivity, flicked light switches repetitively, and mouthed objects.In the office, the patient showed a minimal response to clinicians' social overtures and poor eye contact. He replayed videos on a smartphone while laughing, spinning around, and flapping his hands. He did not respond to prompts for joint engagement and no imaginative play was observed. When the videos stopped, he repeatedly climbed onto chairs and jumped off. As clinicians attempted to redirect him, he became very agitated and his mother intervened physically to protect him from self-injury. Related article page 514 WHAT WOULD YOU DO NEXT? A. Referral of family members for genetic testing to determine 16p11.2 carrier status B. Pharmacotherapy with R-baclofen based on the mouse model of 16p11.2 deletion C. Pharmacotherapy with citalopram for rigidity and repetitive behavior D. Referral to a behavioral intervention program plus pharmacotherapy with aripiprazole for irritability, agitation, and self-injury Clinical Review & Education

show abstract

Metformin for Treatment of Overweight Induced by Atypical Antipsychotic Medication in Young People With Autism Spectrum Disorder

Abstract: clinicaltrials.gov Identifier: NCT01825798.

Cited by 102 publications

References 40 publications

Commentary: A Randomized, Double-Blind, Placebo-Controlled Trial of Metformin Treatment of Weight Gain Associated with Initiation of Atypical Antipsychotic Therapy in Children and Adolescents

Commentary: A Randomized, Double-Blind, Placebo-Controlled Trial of Metformin Treatment of Weight Gain Associated with Initiation of Atypical Antipsychotic Therapy in Children and Adolescents

Metformin as a Possible Intervention for Cardiometabolic Risks in Pediatric Subjects Exposed to Antipsychotic Drugs

Evaluation and Management of Self-injury in a Child With a Rare Genomic Variant

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