American Board Certified Consultant Endocrinologist. Head of Endocrinology Department. Talented Diabetologist. Obesity Expert. Passionate about Metabolic Syndrome, CardioMetabolic Health, Weight Management, and Thyroid.
🟢 New Guidelines (attached in comments ⬇️⬇️) Metformin should be prescribed when initiating antipsychotic treatment in order to prevent antipsychotic-induced weight gain (AIWG) in certain scenarios, a new evidence-based guideline recommends.
We are receiving many referrals from psychiatrists for weight management: GLP-1 are more powerful for weight loss but more expensive and not covered by insurance. Metformin is safe and cheap, it will prevent weight gain and the metabolic complications of antipsychotics: insulin resistance, prediabetes, DM type 2.
Interesting, from a preventive health physician perspective, what do you think about promoting more a healthier life style and activity than prescription of metformin for weight gain. Healthy life style especially daily exercises do more than metformin can do and have a significant healthy effect on mental health and reduce appetite too. With encouragement of physical activity, there is no blood tests montoring required and it has no side effects. So over all a less burden for patients and health economy.
It is worthwhile to check baseline B12 levels along with eGFR, as B12 deficiency can contribute to neuropsychiatric symptoms. Additionally, the use of metformin can potentially exacerbate B12 deficiency.
Insightful - the paradigm is shifting at last. What we ingest matters. Metabolic informed individualised psychiatry is the future thanks to the likes of Chris Palmer MD, Prof Georgia Ede and the Metabolic Mind research group. Great to see what they are doing in the UK and Prof Daniel Smith at Edinburgh University. https://www.mentalhealthplatform.ac.uk/news/ukri-mental-health-platform-launches They are light for those with lived experience of Serious Mental Illness and their loved ones. Thank you.
Honestly this metformin will never let you down... from 1954 till 2024 it's retaining the brand name gluco-phage (glucose eater) as the French scientists first named it. And every year we keep getting another positive outcome from metformin which keeps proving that "old is really gold "
Thank you for sharing this important guideline on preventing antipsychotic-induced weight gain. It's great to see that metformin is being recognized as a potential solution in certain scenarios. However, it's important to note that individualized treatment plans should be developed based on the patient's specific needs and medical history. It's also important to consider lifestyle interventions, such as diet and exercise, in conjunction with medication. Overall, this guideline is a step in the right direction towards improving the overall health and well-being of patients receiving antipsychotic treatment.
Interesting - is there studies evaluating the impact of GLP 1 medications of psychiatric medications especially medications such as lithium? Even the impact of metformin on absorption of psychiatric medications would be an interesting read.
This is such low hanging fruit and has been known for years already. I believe psychiatrists should get comfortable prescribing metformin at the initiation of antipsychotic therapy or they should immediately refer for co-management with a cardiometabolic specialist.
Excelente guía, una forma segura para el manejo de la salud mental en la población con problemas de sobrepeso y/u obesidad
American Board Certified Consultant Endocrinologist. Head of Endocrinology Department. Talented Diabetologist. Obesity Expert. Passionate about Metabolic Syndrome, CardioMetabolic Health, Weight Management, and Thyroid.
1dhttps://academic.oup.com/schizophreniabulletin/advance-article/doi/10.1093/schbul/sbae205/7919241