Metformin May Prevent Weight Gain from Antipsychotic Drugs

A common treatment for type 2 diabetes may be an effective way to promote weight management in younger patients with autism spectrum disorder (ASD) who are taking antipsychotic medications.

Some children and adolescents with ASD are prescribed antipsychotics to treat irritability and agitation. Metformin was shown to help this population reduce or maintain their body mass index (BMI), according to a study published by the Journal of the American Medical Association Psychiatry.

“This is a very special group, as young people with ASD present with many unique challenges,” said lead researcher Michael Aman, PhD. “By definition, they experience communication difficulties, and they're reported to have more gastrointestinal (GI) difficulties than most other patient groups.”

If not controlled, a high BMI can lead to adverse effects, such as diabetes. A recent study has also shown that a high BMI during midlife can result in changes to the brain.

Obese or overweight patients have brain aging accelerated by approximately 10 years, according to the study. Controlling body weight at a young age is a way to prevent adverse effects later in life.

“It's critically important that we investigate new ways to support healthy outcomes as early as possible for those who are on these medications,” said principal investigator of the current study Dr. Evdokia Anagnostou, MD.

Included in the study were 60 patients 6- to 17-years-old with autism spectrum disorders, whose treatment with antipsychotics resulted in weight gain. Researched examined the efficacy of metformin in preventing weight gain associated with the drugs compared with placebo, according to the study.

“Use of antipsychotics to help manage irritability associated with ASD can sometimes be long-term, which means we need to provide families with solutions that support lasting optimal health in their children,” Dr Anagnostou said. “Our results showed that GI side effects occurred for more days in the metformin group compared to placebo group, but the large majority of children taking metformin were able to maintain their treatment. Importantly, the metformin didn't cause behavioral changes, such as increased irritability.”

Researchers believe their findings are promising for weight management in this population. However, they also said food selection is another challenge faced by patients with ASD that could present an additional treatment opportunity.

"It's not the amount that's eaten, rather the food choices that are a by­product of the cravings and linked to weight gain,” Dr Aman concluded.