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Cited by 123Schizophrenia research and treatmentPharmacology and Obesity TreatmentDiabetes Treatment and Management

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Metformin for Clozapine Associated Obesity: A Systematic Review and Meta-Analysis

Open access
Siskind, Dan J., Leung, Janni, Russell, Anthony W., Wysoczanski, Daniel, Kisely, Steve·2016·PLoS ONE
DOI 10.1371/journal.pone.0156208PMC PMC4909277
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Abstract

BACKGROUND: Although clozapine is the gold-standard for treatment refractory schizophrenia, it has the worst metabolic profile of all antipsychotics. This is partly mediated by clozapine's impact on glucagon-like peptide (GLP-1). There is an absence of robust evidence for effective treatments for clozapine associated weight gain and metabolic syndrome. Metformin, with its role in increasing GLP-1 may aid weight loss among people on clozapine. METHODS: We conducted a systematic-review and meta-analysis of metformin versus placebo for change in weight and metabolic syndrome for people on clozapine without diabetes mellitus. We searched the Cochrane Schizophrenia Group's trial register, Pubmed and Embase, as well as the following Chinese databases: the Chinese Biomedical Literature Service System and China Knowledge Resource Integrated Database. This was supplemented by hand searches of key papers. RESULTS: Eight studies, of which three were from Chinese databases, with 478 participants were included. We found that metformin was superior to placebo in terms of weight loss (-3.12kg, 95%CI -4.88kg to -1.37kg) and BMI (-1.18kg/m2, 95%CI -1.76kg/m2 to -0.61kg/m2). Metformin significantly improved three of the five components of metabolic syndrome; waist circumference, fasting glucose and triglycerides. Sensitivity analysis on study quality and duration did not greatly impact results. CONCLUSIONS: Metformin led to clinically meaningful weight loss among people on clozapine, and may reduce the rates of metabolic syndrome. Inclusion of metformin into the treatment protocols of people on clozapine, as tolerated, should be considered. TRIAL REGISTRATION: PROSPERO registration number: CRD42015029723.

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Crossref · 10.1371/journal.pone.0156208

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Fig 1 PRISMA Flow Diagram.
Fig 1 PRISMA Flow Diagram.CC BY · PubMed Central
Fig 2 Forest Plot of Weight, BMI and Waist Circumference*. *weight = body weight in kg; BMI = Body Mass Index in kg/m2; Waist = waist circumference in cm.
Fig 2 Forest Plot of Weight, BMI and Waist Circumference*. *weight = body weight in kg; BMI = Body Mass Index in kg/m2; Waist = waist circumference in cm.CC BY · PubMed Central
Fig 3 Forest Plot of Metabolic Syndrome Components (excluding Waist Circumference). HDL = High Density Lipoprotein; Systolic = Systolic Blood Pressure (in mmHg); Diastolic = Diastolic Blood Pressure (in mmHg).
Fig 3 Forest Plot of Metabolic Syndrome Components (excluding Waist Circumference). HDL = High Density Lipoprotein; Systolic = Systolic Blood Pressure (in mmHg); Diastolic = Diastolic Blood Pressure (in mmHg).CC BY · PubMed Central
Fig 4 Forest Plot of LDL, Insulin and HOMA*. * LDL = Low Density Lipoprotein; HOMA = Homeostatic Model Assessment.
Fig 4 Forest Plot of LDL, Insulin and HOMA*. * LDL = Low Density Lipoprotein; HOMA = Homeostatic Model Assessment.CC BY · PubMed Central

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Research works printed but not linked: 2

  1. H Liu, 2012, Effects of metformin hydrochloride on body mass and blood sugar of convalescence schizophrenics on clozapine, J Clin Psychosom Dis, 18, 97
  2. W Wu, 2014, Metformin hydrochloride auxiliary clozapine impact on patients weight and blood sugar treatment refractory schizophrenia, Chinese People's Health, 26, 68

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Metadata

Authors
Siskind, D. J., Leung, J., Russell, A. W., Wysoczanski, D., & Kisely, S.
Affiliations
  • The University of Queensland (AU)
  • Griffith University (AU)
Corresponding author
Siskind, Dan J.
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2016-06-15
Volume
11
Issue
6
Pages
e0156208
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0156208
PMC
PMC4909277
OpenAlex
W2436128242
Cited by
122
References
32
Citations by year
2026: 7 · 2025: 13 · 2024: 10 · 2023: 9 · 2022: 15 · 2021: 22 · 2020: 14 · 2019: 10 · 2018: 12 · 2017: 7 · 2016: 3
FWCI
1.53
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Griffith Research Online (submittedVersion, cc-by)
Funders
University of Queensland
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
metformin, clozapine, obesity, metabolic syndrome, weight loss, glucagon-like peptide-1, antipsychotic adverse effects, treatment-resistant schizophrenia, body mass index, waist circumference, fasting blood glucose, triglycerides
MeSH terms
Blood Glucose, Body Weight, Clozapine, Fasting, Humans, Hypoglycemic Agents, Metformin, Obesity, Schizophrenia, Antipsychotic Agents, Triglycerides, Weight Gain, Body Mass Index, Randomized Controlled Trials as Topic, Treatment Outcome, Metabolic Syndrome, Waist Circumference

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