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Diabetes Medicine Controls Weight Gain Due to Antipsychotic Medicines

Friday, December 08, 2006

In recent years, the use of atypical antipsychotic medications to treat psychiatric illness in children and adolescents has grown dramatically. While these medications, such as Risperdal" (risperidone), Zyprexa" (olanzapine) and Seroquel" (quetiapine), effectively control many symptoms, their success is also associated with substantial weight gain and even diabetes, causing many people to stop taking them.

But a new study shows that metformin, an oral diabetes medicine that helps control blood sugar levels, not only reduces weight gain but decreases insulin sensitivity. The finding may "improve patient adherence to treatment and thus treatment outcome," according to David Klein, MD, PhD, an endocrinologist at Cincinnati Children's Hospital Medical Center and lead author of the study.

The study is published in the American Journal of Psychiatry, the official journal of the American Psychiatric Association.

"The early recognition of psychosis in children has led to significant improvement in their clinical course, because of early treatment," says Robert Freedman, MD, editor-in-chief of the American Journal of Psychiatry. "Earlier this year, we published evidence that the suicide rate in these children is decreased with early identification and treatment. An unfortunate consequence for the children and their families is the massive weight gain caused by the medications used in their treatment. This study is the first to indicate an effective intervention to help these children return to more normal weight."

The researchers studied 39 children between the ages of 10 and 17 whose weight had increased more than 10 percent during less than one year of olanzapine, risperidone or quetiapine therapy. Eighteen patients took metformin for 16 weeks in combination with one of these atypical antipsychotics. Twenty took a placebo for the same amount of time.

"Over this four-month period, patients taking placebo gained an additional 8.8 pounds, on average, while those taking metformin had a decrease in weight of 0.2 pounds," says Dr. Klein. "Metformin therapy is safe and effective in abrogating weight gain, decreased insulin sensitivity and abnormal glucose metabolism resulting from treatment of children and adolescents with atypicals." The study was partially supported by an investigator-initiated award from Eli Lilly and Company, makers of Zyprexa.

Cincinnati Children's Hospital Medical Center, one of the leading pediatric research institutions in the nation, is dedicated to changing the outcome for children throughout the world. Cincinnati Children's ranks second among all pediatric institutions in the United States in grants from the National Institutes of Health. It has an established tradition of research excellence, with discoveries including the Sabin oral polio vaccine, the surfactant preparation that saves the lives of thousands of premature infants each year, and a rotavirus vaccine that saves the lives of hundreds of thousands of infants around the world each year. Current research directions include the translation of basic laboratory research into the development of novel therapeutics for the treatment of disease, and furthering the development of personalized and predictive medicine.