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In this issue of JAMA Psychiatry, Anagnostou et al1 present results of a double-blind, placebo-controlled study of metformin for weight management in children and adolescents with autism spectrum disorder (ASD) treated with an atypical antipsychotic medication. Metformin was significantly more efficacious than the placebo for decreasing weight gain associated with the use of atypical antipsychotics in this population. The primary disadvantage for the active treatment group was a significantly higher percentage of treatment days with associated gastrointestinal adverse events during the 16 weeks of the trial. There was no difference in change in metabolic parameters measured in blood, including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, glucose, fasting insulin, or hemoglobin A1C, between the metformin and placebo groups.
McDougle CJ. Atypical Antipsychotic-Induced Weight Gain in Children and AdolescentsSometimes Less Is More. JAMA Psychiatry. 2016;73(9):899-901. doi:10.1001/jamapsychiatry.2016.1213