Efficacy of metformin for prevention of weight gain in psychiatric populations: a review

Int Clin Psychopharmacol. 2012 Mar;27(2):69-75. doi: 10.1097/YIC.0b013e32834d0a5b.


There is uncertainty with regard to the appropriate use of metformin for the prevention and management of second-generation antipsychotic-induced weight gain and metabolic abnormalities. We aim to systematically review the primary literature and to provide recommendations with regard to the use of metformin in psychiatric populations prescribed second-generation antipsychotics. The authors undertook a literature search of Medline, EMBASE, and PsycINFO using the search terms; antipsychotic OR atypical antipsychotic AND weight AND metformin. Narrative review was undertaken without additional statistical analysis. The search provided 198 results from which 10 original research papers were identified: six randomized controlled trials and one open-label study for adults and two randomized controlled trials and one open-label study for children and adolescents. Four meta-analyses were also identified. We concluded that if weight gain occurs after second-generation antipsychotic initiation, despite lifestyle intervention, metformin should be considered. Further studies with adequate statistical power are required to determine the efficacy of metformin in those with chronic psychotic illness.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Anti-Obesity Agents / therapeutic use*
  • Antidepressive Agents, Second-Generation / adverse effects
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Child
  • Drug Monitoring
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Mental Disorders / drug therapy*
  • Mental Disorders / metabolism
  • Metformin / therapeutic use*
  • Overweight / chemically induced
  • Overweight / prevention & control*
  • Overweight / psychology
  • Weight Gain / drug effects*


  • Anti-Obesity Agents
  • Antidepressive Agents, Second-Generation
  • Antipsychotic Agents
  • Hypoglycemic Agents
  • Metformin