Evidence map›Paper›PMID 17151157›Full record

Trial reportThe American journal of psychiatry2006

A randomized, double-blind, placebo-controlled trial of metformin treatment of weight gain associated with initiation of atypical antipsychotic therapy in children and adolescents.

David J Klein, Elizabeth M Cottingham, Michael Sorter, Bruce A Barton, John A Morrison

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The American journal of psychiatry, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 11 pooled it
12.3field-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.

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.

2 · 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 11 syntheses or guidelines pooled it, 258 citations in OpenAlex.

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  6. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2017 · on this map
    Guideline
  7. Drug interventions for the treatment of obesity in children and adolescents.The Cochrane database of systematic reviews · 2016
    Pooled it
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  9. Metformin for olanzapine-induced weight gain: a systematic review and meta-analysis.British journal of clinical pharmacology · 2011 · on this map
    Pooled it
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  11. Effectiveness of medications used to attenuate antipsychotic-related weight gain and metabolic abnormalities: a systematic review and meta-analysis.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2010
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23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

David J KleinDivision of Endocrinology, Cincinnati Children's Hospital Medical Center, ML 7012, 3333 Burnet Ave., Cincinnati, OH 45229, USA. david.klein@cchmc.org
Elizabeth M Cottingham
Michael Sorter
Bruce A Barton
John A Morrison
Cincinnati Children's Hospital Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSecond-generation, or atypical, antipsychotics effectively treat psychiatric illness in children and adolescents. However, weight gain and abnormalities in insulin sensitivity, including diabetes, complicate this therapy.

methodA 16-week double-blind, placebo-controlled trial was conducted to evaluate the effectiveness of metformin in managing weight gain in 39 subjects, ages 10-17, whose weight had increased by more than 10% during less than 1 year of olanzapine, risperidone, or quetiapine therapy. Body weight, body mass index (kilograms per square meter of height), and waist circumference were measured regularly, as were fasting insulin and glucose levels.

resultsWeight was stabilized in subjects receiving metformin, while those receiving placebo continued to gain weight (0.31 kg/week). Because the study was conducted with growing children, metformin treatment resulted in reduction in z scores for both weight and body mass index. The homeostasis model assessment, a surrogate indicator of insulin sensitivity, decreased in treated subjects. Overt diabetes was diagnosed in two subjects before treatment (elevated baseline fasting glucose and insulin values) and in two placebo-treated subjects (one at week 12 and the other after study completion). One subject taking placebo developed impaired fasting glucose. Placebo treatment was associated with the need to perform oral glucose tolerance testing upon study completion, by which three additional subjects were identified with impaired glucose tolerance. No serious adverse events resulted from metformin treatment.

conclusionsMetformin therapy is safe and effective in abrogating weight gain, decreased insulin sensitivity, and abnormal glucose metabolism resulting from treatment of children and adolescents with atypicals.

Indexed as

AdolescentAge FactorsAntipsychotic AgentsBlood GlucoseBody Mass IndexChildDiabetes Mellitus, Type 2Double-Blind MethodGlucose Tolerance TestHumansHypoglycemic AgentsInsulinInsulin ResistanceMental DisordersMetforminObesityAntipsychotic AgentsBlood GlucoseHypoglycemic AgentsInsulinMetforminPlacebos

Identifiers

PMID17151157
OpenAlexW2170708988

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

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 OpenQuestion graph.