The potential effect of metformin on cognitive and other symptom dimensions in patients with schizophrenia and antipsychotic-induced weight gain: a systematic review, meta-analysis, and meta-regression
Articolo
Data di Pubblicazione:
2023
Citazione:
The potential effect of metformin on cognitive and other symptom dimensions in patients with schizophrenia and antipsychotic-induced weight gain: a systematic review, meta-analysis, and meta-regression / V. Battini, G. Cirnigliaro, R. Leuzzi, E. Rissotto, G. Mosini, B. Benatti, M. Pozzi, M. Nobile, S. Radice, C. Carnovale, B. Dell'Osso, E. Clementi. - In: FRONTIERS IN PSYCHIATRY. - ISSN 1664-0640. - 14:(2023 Jul), pp. 1215807.1-1215807.15. [10.3389/fpsyt.2023.1215807]
Abstract:
ntroduction: Metformin has shown good efficacy in the management of
antipsychotic-induced metabolic syndrome (MetS) in patients with schizophrenia
or schizoaffective disorders. Its ability to induce antidepressant behavioural
effects and improve cognitive functions has also been investigated: yet
information has not been systematized. The aim of this study was therefore to
investigate the effects of metformin on cognitive and other symptom dimension
in schizophrenic patients treated with antipsychotics through a systematic review
and meta-analysis.
Methods: We searched PubMed, ClinicalTrials.Gov, Embase, PsycINFO, and
WHO ICTRP database up to February 2022, Randomised Controlled Trials (RCT)
evaluating patients diagnosed with schizophrenia and related disorders, who were
treated with metformin as add-on therapy to antipsychotics for the treatment
of weight gain and in which changes in psychiatric symptoms and cognitive
functions were evaluated.
Results: A total of 19 RCTs met the inclusion criteria. Meta-analysis was
performed on 12 eligible studies. We found a positive trend after 24 weeks of
treatment in schizophrenic patients with stable conditions [SMD (95%CI) = -0.40
(−0.82;0.01), OR (95%CI) = 0.5 (−2.4;3.4)]. Better performance was detected in
the Brief Assessment of Cognition in Schizophrenia and Positive and Negative
Syndrome Scale (PANSS) with low heterogeneity among studies. One study
reported changes in BACS-verbal memory subdomain in favour of placebo
[MD (95%CI) = -16.03 (-23.65;8.42)]. Gastrointestinal disorders, xerostomia, and
extrapyramidal syndrome were the most reported adverse effects. Psychiatric
adverse events were also described: in particular, symptoms attributable to a
relapse of schizophrenia.
Conclusion: Some degree of efficacy was found for Metformin in improving
cognitive and other symptom dimensions in patients with Schizophrenia. Given
the clinical relevance of this potential pharmacological effect, longer specific
studies using adequate psychometric scales are strongly recommended. Likewise,
how metformin acts in this context needs to be evaluated in order to enhance its
efficacy or find more efficacious drugs.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
cognitive disorders; hypoglycemic drugs; meta-analysis; metformin; schizophrenia
Elenco autori:
V. Battini, G. Cirnigliaro, R. Leuzzi, E. Rissotto, G. Mosini, B. Benatti, M. Pozzi, M. Nobile, S. Radice, C. Carnovale, B. Dell'Osso, E. Clementi
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