ArticleSchizophrenia bulletin2025
Metformin for the Prevention of Antipsychotic-Induced Weight Gain: Guideline Development and Consensus Validation.
Article in Schizophrenia bulletin, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 5 of them syntheses that pooled 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.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Clinical Practice Guideline on the Pharmacological Management of Antipsychotic-Related Dyslipidemia.Schizophrenia bulletin · 2026Guideline
- Interventions to prevent antipsychotic-induced weight gain and metabolic complications in individuals with a first-episode psychosis and minimal antipsychotic exposure: a systematic review and meta-analysis.Psychological medicine · 2026Pooled it
- Guideline
- Short-, Medium-, and Long-Term Cardiometabolic Outcomes in First-Episode Psychosis: A Systematic Review and Meta-analysis.Schizophrenia bulletin · 2026Pooled it
- Adjunctive berberine for schizophrenia with metabolic syndrome: a systematic review and meta-analysis.Frontiers in psychiatry · 2026Pooled it
- Closing the Gap: A Primary Care Refresher for Psychiatry Residents.Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry · 2026Article
- Efficacy and safety of add-on topiramate vs. metformin on cardiometabolic profile in patients of schizophrenia on atypical antipsychotics with metabolic syndrome: an active-controlled, rater-blinded, parallel-design randomized controlled trial.European archives of psychiatry and clinical neuroscience · 2026Article
- Weight loss prior to diagnosis of first-episode psychosis predicts subsequent weight gain: a retrospective cohort study of the UK Clinical Practice Research Datalink (CPRD) primary care database.BMJ mental health · 2026Article
- Effectiveness of a Psychiatrist-Led Clinic for Metabolic Health in Severe Mental Illness: A Retrospective Chart Review Study.Acta psychiatrica Scandinavica · 2026Article
- Review
- Review
- The Effect of Semaglutide on Antipsychotic-Induced Weight Gain and Other Metabolic Parameters, among a Cohort of Inpatients.Schizophrenia bulletin · 2026Article
- Proportion and Reasons for Clozapine Discontinuation: A Systematic Review and Meta-Analysis.Schizophrenia bulletin open · 2026Review
- Treatment of obesity with liraglutide in bipolar disorder: a case report.Frontiers in psychiatry · 2026Article
- Metformin Alone and in Combinations Alter the Methylation Patterns ofEndocrine, metabolic & immune disorders drug targets · 2026Article
- Comparative efficacy and safety of liraglutide versus metformin, naltrexone/bupropion, and phentermine-topiramate in psychiatric patients.Therapeutic advances in psychopharmacology · 2026 · on this mapArticle
- Managing schizophrenia with affective, sexual, metabolic and substance-use comorbidities: pharmacological considerations from an expert consensus.Annals of general psychiatry · 2025Article
- GLP-1R Agonists for Weight Loss in Psychiatric Disorders: A Systematic Review and Meta-analysis.Journal of the Endocrine Society · 2025Review
- Prevention of Antipsychotic-Induced Weight Gain: Beyond Metformin.Schizophrenia bulletin · 2025Article
- The Inflammatory Nexus: Unraveling Shared Pathways and Promising Treatments in Alzheimer's Disease and Schizophrenia.International journal of molecular sciences · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors.
Funding
Abstract
backgroundOverweight and obesity are highly prevalent in people with severe mental illness (SMI). Antipsychotic-induced weight gain (AIWG) is one of the most commonly reported and distressing side effects of treatment and people living with SMI place a high value on the avoidance of this side effect. Metformin is the most effective pharmacological intervention studied for the prevention of AIWG yet clear guidelines are lacking and evidence has not translated into practice. The aim of this research was to develop a guideline for the use of metformin for the prevention of AIWG. STUDY
designThe appraisal of guidelines for research and evaluation II instrument (AGREE II) was followed for guideline development. Literature was reviewed to address key health questions. The certainty of evidence was evaluated using GRADE methodology and an evidence-to-decision framework informed the strength of the recommendations. A consensus meeting was held where the algorithm and strength of recommendations were agreed. An independent external review was conducted involving experts in the field, including patient and public partners. STUDY
resultsMetformin is the only pharmacological agent that has demonstrated efficacy for preventing AIWG. Co-commencement with antipsychotic medicines can reduce the extent of weight gain by 4.03 kg (95% CI -5.78 kg to -2.28 kg) compared to controls. A guideline for the use of metformin for the prevention of AIWG was developed with specific recommendations for co-commencement of metformin at initiation with an antipsychotic or commencement if certain criteria are present. Core recommendations were graded as strong by consensus agreement.
conclusionsThis is the first published evidence-based guideline using the AGREE II framework and GRADE methods for the use of metformin to prevent AIWG incorporating recommendations for co-commencement. Implementation and evaluation of the guideline will be supported by a shared decision-making package and assessment of barriers and facilitators to implementation.
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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.