Trial reportThe American journal of psychiatry2013

Metformin for weight loss and metabolic control in overweight outpatients with schizophrenia and schizoaffective disorder.

L Fredrik Jarskog, Robert M Hamer, Diane J Catellier, Dawn D Stewart, Lisa Lavange, Neepa Ray, Lauren H Golden, Jeffrey A Lieberman, T Scott Stroup, METS Investigators

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The American journal of psychiatry, 2013. The graph read 2 numbers from its abstract, feeding 1 cell of the map: it supports the treatment in 1. It is linked to trial NCT02796144 (Metformin and Lorcaserin for Weight Loss in Schizophrenia), which is not on this map. Cited by 50 papers, 12 of them syntheses that pooled it.

2numbers the graph read from it
1cell of the map it votes in
50citing papers in PubMed, 12 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
-4.000 · no effect
Body weight & compositionfavours the treatment · against placebo · obesityfeeds one cell of the map
mean change -3.00-4.00 to -2.00
Mean change in body weight was -3.0 kg (95% CI=-4.0 to -2.0) for the metformin group and -1.0 kg (95% CI=-2.0 to 0.0) for the placebo group, with a between-group difference of -2.0 kg (95% CI=-3.4 to -0.6).
Body weight & compositionfavours the treatment · against placebo · obesityfeeds one cell of the map
Δ -2.00-3.40 to -0.60
Mean change in body weight was -3.0 kg (95% CI=-4.0 to -2.0) for the metformin group and -1.0 kg (95% CI=-2.0 to 0.0) for the placebo group, with a between-group difference of -2.0 kg (95% CI=-3.4 to -0.6).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Metformin×body weight & composition

SupportsOpen on the map →What to test next →

19 readable studies in this cell: 7 favour the treatment, 6 find no difference, 6 favour the comparator.

Belief with this paper
0.50contested · 8 families support, 4 contradict · against placebo
Without it
0.50This paper does not move the number.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2013
mean change -3.00-4.00 to -2.00
NCT018093271,186 enrolled · 2013
Δ -0.90-1.60 to -0.20
NCT008598981,093 enrolled · 2009
Δ -1.37-2.03 to -0.71
NCT00643851994 enrolled · 2008
Δ -0.05-0.72 to 0.61
NCT02932475831 enrolled · 2017
Δ 0.04
NCT00676338820 enrolled · 2008
Δ -0.04-0.61 to 0.53
NCT02980276535 enrolled · 2017
Δ -0.70-1.30 to -0.20
Δ 17.05.00 to 29.0
increase 1.26-0.24 to 2.75
weight loss -16.2-60.2 to -4.40
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02796144 phase4terminatednot on this mapstarted 2016, after this paper: background citation

Metformin and Lorcaserin for Weight Loss in Schizophrenia

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2016 to 2020Enrolled71ConditionsSchizophrenia, Schizoaffective Disorder, OverweightArmsLorcaserin, Metformin, Placebo
5 · Its place in the literature

Who cites it

50 citing papers in PubMed, 12 syntheses or guidelines pooled it, 144 citations in OpenAlex.

  1. Pooled it
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  13. Trial
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  16. Article
  17. Novel drug treatments for schizophrenia.Nature reviews. Drug discovery · 2026
    Review
  18. Review
  19. Review
  20. Article
6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

L Fredrik Jarskog
Robert M Hamer
Diane J Catellier
Dawn D Stewart
Lisa Lavange
Neepa Ray
Lauren H Golden
Jeffrey A Lieberman
T Scott Stroup
METS Investigators
University of North Carolina at Chapel Hill · USClinical Insights · US

Funding

PUBLIC EDUCATION CAMPAIGN ON DEPRESSION DARTN01MH090001 · UNIVERSITY OF NORTH CAROLINA CHAPEL HILL · 1989 to 2003
$10.4M
NIMH NIH HHS N01 MH090001NIMH NIH HHS N01MH-90001
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

objectiveThe purpose of this study was to determine whether metformin promotes weight loss in overweight outpatients with chronic schizophrenia or schizoaffective disorder.

methodIn a double-blind study, 148 clinically stable, overweight (body mass index [BMI] ≥27) outpatients with chronic schizophrenia or schizoaffective disorder were randomly assigned to receive 16 weeks of metformin or placebo. Metformin was titrated up to 1,000 mg twice daily, as tolerated. All patients continued to receive their prestudy medications, and all received weekly diet and exercise counseling. The primary outcome measure was change in body weight from baseline to week 16.

resultsFifty-eight (77.3%) patients who received metformin and 58 (81.7%) who received placebo completed 16 weeks of treatment. Mean change in body weight was -3.0 kg (95% CI=-4.0 to -2.0) for the metformin group and -1.0 kg (95% CI=-2.0 to 0.0) for the placebo group, with a between-group difference of -2.0 kg (95% CI=-3.4 to -0.6). Metformin also demonstrated a significant between-group advantage for BMI (-0.7; 95% CI=-1.1 to -0.2), triglyceride level (-20.2 mg/dL; 95% CI=-39.2 to -1.3), and hemoglobin A1c level (-0.07%; 95% CI=-0.14 to -0.004). Metformin-associated side effects were mostly gastrointestinal and generally transient, and they rarely led to treatment discontinuation.

conclusionsMetformin was modestly effective in reducing weight and other risk factors for cardiovascular disease in clinically stable, overweight outpatients with chronic schizophrenia or schizoaffective disorder over 16 weeks. A significant time-by-treatment interaction suggests that benefits of metformin may continue to accrue with longer treatment. Metformin may have an important role in diminishing the adverse consequences of obesity and metabolic impairments in patients with schizophrenia.

Indexed as

MetforminPsychotic DisordersSchizophreniaAdultAntipsychotic AgentsBody Mass IndexDose-Response Relationship, DrugDouble-Blind MethodDrug MonitoringFemaleGlycated HemoglobinHumansHypoglycemic AgentsMaleMetabolic DiseasesMiddle AgedAntipsychotic AgentsGlycated HemoglobinHypoglycemic AgentsMetformin

Identifiers

PMID23846733
PMCPMC3874085
OpenAlexW2137293650

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.