Metabolic and clinical profiles of young people with mood or psychotic disorders who are prescribed metformin in an inpatient setting

Australas Psychiatry. 2022 Dec;30(6):689-693. doi: 10.1177/10398562221115607. Epub 2022 Jul 19.

Abstract

Objective: Youth with early-onset mood or psychotic disorders are occasionally prescribed metformin to manage cardiometabolic risk. This retrospective study explores the demographic, clinical and metabolic factors associated with metformin prescription youth with mood or psychotic disorders.

Method: Participants included 72 youth with mood or psychotic disorders from a young adult mental health inpatient unit, of which 18 (33%) were newly prescribed metformin, and 54 (66%) were not prescribed metformin. Demographic and clinical information were extracted from the patients' medical files along with body mass index (BMI), fasting serum bloods and calculated updated homeostatic model of insulin resistance assessment (HOMA2-IR) scores to compare profiles between groups.

Results: Of those prescribed metformin, 83% were overweight or obese and 72% had elevated HOMA2-IR scores. Of those not receiving metformin treatment, 41% were overweight or obese and 22% had elevated HOMA2-IR scores. Youth prescribed metformin had significantly higher BMI, and elevated markers of insulin resistance, but did not differ to those not prescribed metformin on other demographic, clinical or metabolic factors.

Conclusions: While metformin is prescribed to some youth with mood or psychotic disorders displaying markers of cardiometabolic disturbance, there is a need to develop clearer treatment guidelines for metformin in these youth.

Keywords: cardiometabolic risk factors; glucose metabolism; insulin-resistance; metformin; youth mood and psychotic disorders.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Cardiovascular Diseases*
  • Humans
  • Inpatients
  • Insulin Resistance*
  • Metformin* / therapeutic use
  • Obesity / complications
  • Overweight
  • Psychotic Disorders* / complications
  • Psychotic Disorders* / drug therapy
  • Retrospective Studies
  • Young Adult

Substances

  • Metformin