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Brief Report: Metformin for Antipsychotic-Induced Weight Gain in Youth with Autism Spectrum Disorder

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Abstract

Antipsychotic treatment in youth with autism spectrum disorder (ASD) is becoming increasingly common, placing individuals at risk for antipsychotic-induced weight gain and associated complications. Metformin hydrochloride, a biguanide medication FDA-approved for treatment of type-2 diabetes in youth, may hold promise for treatment of antipsychotic-induced weight gain in youth with ASD. In this report we assess the long-term impact of metformin on antipsychotic-associated weight gain in a naturalistic sample of 53 youth with ASD. Results indicate that treatment with metformin stabilized BMI z-score over a nearly 2 year mean treatment period. Further work is indicated to determine the safety and efficacy of metformin treatment in youth with ASD, as well as predictors of response as a treatment for antipsychotic-induced weight gain.

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Acknowledgments

The authors would like to acknowledge the contribution of Sihame Amlal for her help with data collection.

Author Contributions

LKW was involved in all aspects of this research including conceptualization, design, execution, and composition of the manuscript. RA completed the statistical design and analysis for this project. EVP and KCD were involved in project conceptualization and reviewed the manuscript in detail. CB and EF completed all data collection and were involved in manuscript review. CAE was involved in all aspects of the project including conceptualization, execution, and manuscript completion.

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Authors and Affiliations

  1. Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH, 45229, USA

    Logan K. Wink, Ryan Adams, Ernest V. Pedapati, Kelli C. Dominick, Emma Fox, Catherine Buck & Craig A. Erickson

Authors
  1. Logan K. Wink
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  2. Ryan Adams
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  3. Ernest V. Pedapati
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  4. Kelli C. Dominick
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  5. Emma Fox
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  6. Catherine Buck
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  7. Craig A. Erickson
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Corresponding author

Correspondence to Logan K. Wink.

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Conflict of interest

The authors report no direct conflicts of interest with this report. Dr. Wink’s current research is supported by the Simons Research Foundation, Autism Speaks, Roivant Sciences Ltd, and Cures Within Reach. Dr. Wink has served as a past consultant for Otsuka. Dr. Pedapati receives research support from the Cincinnati Children’s Hospital Research Foundation. Dr. Erickson is a consultant to and holds equity in Confluence Pharmaceuticals and is a consultant to Neurotrope and Fulcrum. Dr. Erickson is a past consultant to Alcobra Pharmaceuticals, the Roche Group, and Novartis. Dr. Erickson holds non-related IP held by CCHMC and Indiana University. Dr. Erickson receives or has received research grant support from the John Merck Fund, Indiana University School of Medicine, Cincinnati Children’s Hospital Medical Center, Autism Speaks, the United States Department of Defense, the Simons Foundation, the United States Centers for Disease Control, the National Fragile X Foundation, The Roche Group, Neuren Pharmaceuticals, the National Institutes of Health, and Roivant Sciences Ltd. Dr. Adams, Dr. Dominick, Ms. Fox, and Ms. Buck have no conflicts to report.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

As this work was a chart review study, need for informed consent by participants was waived by our IRB.

Appendix

Appendix

Complete Drug List by Category

Antipsychotics: aripiprazole, asenapine, chlorpromazine, clozapine, haloperidol, olanzapine, paliperidone, quetiapine, risperidone, thioridizine, ziprasidone.

Antidepressants: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, sertraline.

Anxiolytics: buspirone, clonazepam, hydroxyzine, lorazepam, propranolol.

Stimulants: amphetamine, dexmethylphenidate, dextroamphetamine, lisdexamphetamine, methylphenidate, methylphenidate ER.

Non-stimulant ADHD Medications: atomoxetine, clonidine, guanfacine, guanfacine ER.

Sleep Aids: diphenhydramine, melatonin, ramelteon, trazodone, zolpidem.

Mood Stabilizers/Anti-epileptics: clobazam, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, phenytoin, topiramate, valproic Acid.

Other: acamprosate, n-acetylcysteine, riluzole.

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Wink, L.K., Adams, R., Pedapati, E.V. et al. Brief Report: Metformin for Antipsychotic-Induced Weight Gain in Youth with Autism Spectrum Disorder. J Autism Dev Disord 47, 2290–2294 (2017). https://doi.org/10.1007/s10803-017-3132-2

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  • DOI: https://doi.org/10.1007/s10803-017-3132-2

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