Evidence map›Paper›PMID 33854039›Full record

Trial reportTranslational psychiatry2021

Metformin for early comorbid glucose dysregulation and schizophrenia spectrum disorders: a pilot double-blind randomized clinical trial.

Sri Mahavir Agarwal, Roshni Panda, Kenya A Costa-Dookhan, Nicole E MacKenzie, Quinn Casuccio Treen, Fernando Caravaggio, Eyesha Hashim, General Leung, Anish Kirpalani, Kelly Matheson and 6 more

Registry-linked trialOpen access · goldFull text readRandomized Controlled Trial
In one paragraph

Trial report in Translational psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT02167620. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
2.0field-weighted citation impact, top 13% 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.

NCT02167620 phase4completed

Metformin in Co-morbid Diabetes or Prediabetes and Serious Mental Illness

Ran2014Enrolled35Registered outcomes6Posted comparisons0ConditionsDiabetes Mellitus, Type 2, SchizophreniaArmsMetformin, Placebo
Open the trial in the graph
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Efficacy of Weight-Lowering Agents on Fat Distribution: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
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  8. Repurposing medications to prevent psychosis.Npj mental health research · 2025
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  18. Geroscience-Centric Perspective for Geriatric Psychiatry: Integrating Aging Biology With Geriatric Mental Health Research.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 1 country.

Sri Mahavir AgarwalCentre for Addiction and Mental Health, Toronto, ON, Canada.ORCID 0000-0002-2705-5146
Roshni Panda *Centre for Addiction and Mental Health, Toronto, ON, Canada.
Kenya A Costa-Dookhan *Centre for Addiction and Mental Health, Toronto, ON, Canada.
Nicole E MacKenzieCentre for Addiction and Mental Health, Toronto, ON, Canada.
Quinn Casuccio TreenCentre for Addiction and Mental Health, Toronto, ON, Canada.
Fernando CaravaggioCentre for Addiction and Mental Health, Toronto, ON, Canada.
Eyesha HashimSt. Michael's Hospital, Toronto, ON, Canada.
General LeungSt. Michael's Hospital, Toronto, ON, Canada.
Anish KirpalaniSt. Michael's Hospital, Toronto, ON, Canada.
Kelly MathesonCentre for Addiction and Mental Health, Toronto, ON, Canada.
Araba F ChintohCentre for Addiction and Mental Health, Toronto, ON, Canada.
Caroline K KramerMount Sinai Hospital, Toronto, ON, Canada.
Aristotle N VoineskosCentre for Addiction and Mental Health, Toronto, ON, Canada.ORCID 0000-0003-0156-0395
Ariel Graff-GuerreroCentre for Addiction and Mental Health, Toronto, ON, Canada.
Gary J RemingtonCentre for Addiction and Mental Health, Toronto, ON, Canada.
Margaret K HahnCentre for Addiction and Mental Health, Toronto, ON, Canada. Margaret.Hahn@camh.ca.ORCID 0000-0001-8884-9946
Centre for Addiction and Mental Health · CASt. Michael's Hospital · CAMount Sinai Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with schizophrenia have exceedingly high rates of metabolic comorbidity including type 2 diabetes and lose 15-20 years of life due to cardiovascular diseases, with early accrual of cardiometabolic disease. In this study, thirty overweight or obese (Body Mass Index (BMI) > 25) participants under 40 years old with schizophrenia spectrum disorders and early comorbid prediabetes or type 2 diabetes receiving antipsychotic medications were randomized, in a double-blind fashion, to metformin 1500 mg/day or placebo (2:1 ratio; n = 21 metformin and n = 9 placebo) for 4 months. The primary outcome measures were improvements in glucose homeostasis (HbA1c, fasting glucose) and insulin resistance (Matsuda index-derived from oral glucose tolerance tests and homeostatic model of insulin resistance (HOMA-IR)). Secondary outcome measures included changes in weight, MRI measures of fat mass and distribution, symptom severity, cognition, and hippocampal volume. Twenty-two patients (n = 14 metformin; n = 8 placebo) completed the trial. The metformin group had a significant decrease over time in the HOMA-IR (p = 0.043) and fasting blood glucose (p = 0.007) vs. placebo. There were no differences between treatment groups in the Matsuda index, HbA1c, which could suggest liver-specific effects of metformin. There were no between group differences in other secondary outcome measures, while weight loss in the metformin arm correlated significantly with decreases in subcutaneous, but not visceral or hepatic adipose tissue. Our results show that metformin improved dysglycemia and insulin sensitivity, independent of weight loss, in a young population with prediabetes/diabetes and psychosis spectrum illness, that is at extremely high risk of early cardiovascular mortality. Trial Registration: This protocol was registered with clinicaltrials.gov (NCT02167620).

Indexed as

Diabetes Mellitus, Type 2Insulin ResistanceMetforminSchizophreniaAdultBlood GlucoseDouble-Blind MethodGlucoseHumansHypoglycemic AgentsBlood GlucoseGlucoseHypoglycemic AgentsMetformin

Identifiers

PMID33854039
PMCPMC8046796
OpenAlexW3153610861

What OpenQuestion holds

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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 OpenQuestion graph.