Some antipsychotic medications used to treat autism spectrum disorder in children cause weight gain. Addition of metformin to the treatment allows children to maintain their body weight but is associated with more gastrointestinal discomforts.
Antipsychotic medications (risperidone and aripiprazole) that are given to children with autism spectrum disorders frequently cause weight gain and metabolic complications such as risk of type II diabetes. This is especially problematic for youth and children undergoing long term usage of these medications. Metformin is a drug approved for the treatment of type II diabetes. It increases insulin sensitivity and decreases intestinal glucose absorption as well as hepatic glucose production. Canadian and American researchers evaluated the addition of metformin to the treatment of children with autism spectrum disorders.
For this clinical study, 61 participants were aged 6 to 17 years and were diagnosed with an autism spectrum disorder that requires antipsychotic medications. During a 16-week period, the participants were given either metformin or a placebo and the change in body mass index (BMI) was monitored. Changes in body composition and metabolic variables were also evaluated.
The results, published in JAMA Psychiatry, indicate that the addition of metformin to the antipsychotic medication allowed participants to keep their weight stable while an increase of about 3 kg was observed in the control group that received the placebo with their antipsychotic medication. The BMI z-score compares the BMI of each group with the general population of corresponding age and height. While BMI of the control group was slightly over the mean, the metformin group finished the study with a significantly lower BMI z-score of -0.10. Indeed, while the BMI of the control group increased by 0.52, the BMI of the Metformin group was reduced by -0.43. Interestingly, the changes only appeared after 12 weeks of treatment. Noteworthy, participants who received metformin experienced more gastrointestinal problems than those taking the placebo.
In conclusion, this additional treatment could be useful to control the body weight of children taking antipsychotic medication and prevent the early development of cardiovascular and metabolic disorders.
Written By: Jean-Michel Bourget, PhD