Metformin as a Possible Intervention for Cardiometabolic Risks in Pediatric Subjects Exposed to Antipsychotic Drugs

Children and adolescents who are exposed to antipsychotic medication are at increased risk of weight gain and metabolic dysregulation. Metformin, which has demonstrated efficacy for these adverse treatment outcomes in adult samples, has been examined in pediatric samples, as well. Case reports, 2 uncontrolled studies, and 2 (out of 3) randomized controlled trials have demonstrated that metformin (1,000-1,700 mg/d) treatment for up to 16 weeks is associated with statistically and clinically significant weight loss. There is less consistent evidence, however, for benefits with metformin for glucose and lipid metabolism outcomes. The early institution of metformin in vulnerable patients merits consideration and study.