A new, large-scale study led by researchers at Northwell’s Zucker Hillside Hospital and the University of Cincinnati found the drug metformin can help preventor reduce weight gain in youth taking medication to treat bipolar disorder.
Medications to treat bipolar disorder are often effective in helping to treat symptoms in young people; at the same time, however, they can have significant side effects, most notable being elevated blood pressure, increased appetite and weight gain.
“As doctors, we continue to prescribe these medications because we wanted to help young people deal with their psychosis,” said Victor Fornari, MD, director of child/adolescent psychiatry at Northwell Health. “But, we couldn’t ignore the fact that many young people were gaining weight because of these medication and simply stopped taking their medicine for that reason.
“What we realized is that we had to not only look at the mental health, but also the physical health of the person,” said Dr. Fornari. “Metformin, a medication traditionally used for type 2 diabetes, is known to also prevent weight gain. That’s why we were interested in seeing if it would work for this population.”
A total of 1,565 patients aged 8-19 living with bipolar disorder taking antipsychotic medication were enrolled in the study, a huge accomplishment according to Dr. Fornari.
“It was across 60 sites across the country, and it was a large sample of patients to really demonstrate what’s going on,” he said. “I don’t know that anybody has done a study of this magnitude with almost 1,600 kids and their families.”
The short-term six-month follow-up data revealed that metformin had a modest but significant effect at preventing and in some cases reversing weight gain in the study’s patient population. The drug was also found to be safe, with some gastrointestinal distress symptoms being the only side effect of note.
“It’s safe and very inexpensive, so it’s an intervention that has the potential to have widespread applicability,” Dr. Fornari added. It’s not a medicine that you need an endocrinologist or a pediatrician to prescribe, and I think it really speaks to the fact that the psychiatrist needs to be caring for the entire person, the physical and the mental health of the patient.”
“This class of mood stabilizers are very effective. But their metabolic effects have been a major problem. We are delighted to learn of the results of this joint study between Northwell Health and the University of Cincinnati,” said John Q. Young, MD, MPP, PhD, chair, department of psychiatry, Zucker Hillside Hospital. “Research is a key component of our work here at Zucker; we pride ourselves on finding new ways to help our patients. Dr. Fornari’s work with metformin will prove invaluable to youngsters who will no longer have to decide between taking their medication or maintaining an appropriate weight and metabolic health. This is a groundbreaking achievement.”
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