The adjunctive use of metformin to treat or prevent atypical antipsychotic-induced weight gain: a review

J Psychiatr Pract. 2010 Sep;16(5):289-96. doi: 10.1097/01.pra.0000388624.91039.a3.


Patients with schizophrenia have a greater incidence of being overweight or obese compared with the general population. Such individuals are often treated with second-generation (atypical) antipsychotics (SGAs), which are associated with weight gain, dyslipidemia, and other metabolic derangements. As a result, frequent monitoring of weight and other metabolic parameters is recommended. In addition, several pharmacologic strategies to help prevent or reduce SGA-induced weight gain have been proposed. Despite this, clinicians often struggle to manage obesity and metabolic issues in such patients. Metformin has attracted attention as a potential treatment option because it is thought to result in weight reduction and improved glycemic control in obese patients with and without type 2 diabetes mellitus. This article focuses on relevant pharmacologic aspects of metformin and reviews currently available evidence on the use of metformin as an augmentation agent for the treatment or prevention of SGA-induced weight gain.

Trial registration: NCT00816907.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / adverse effects*
  • Blood Glucose / drug effects
  • Body Weight / drug effects
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Metformin / therapeutic use*
  • Obesity / chemically induced
  • Obesity / drug therapy
  • Overweight / chemically induced*
  • Overweight / drug therapy*
  • Schizophrenia / drug therapy*
  • Treatment Outcome
  • Weight Loss / drug effects


  • Antipsychotic Agents
  • Blood Glucose
  • Hypoglycemic Agents
  • Metformin

Associated data