Evidence map›Paper›PMID 40175159›Full record

ArticleBMJ mental health2025

Co-prescription of metformin and antipsychotics in severe mental illness: a UK primary care cohort study.

Luiza Farache Trajano, Joseph F Hayes, Naomi Launders, Neil M Davies, David P J Osborn, Alvin Richards-Belle

Abstract read
In one paragraph

Article in BMJ mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Luiza Farache TrajanoDivision of Psychiatry, University College London, London, UK.ORCID 0000-0003-0401-3426
Joseph F HayesDivision of Psychiatry, University College London, London, UK.ORCID 0000-0003-2286-3862
Naomi LaundersDivision of Psychiatry, University College London, London, UK.ORCID 0000-0003-4241-938X
Neil M DaviesDivision of Psychiatry, University College London, London, UK.
David P J OsbornDivision of Psychiatry, University College London, London, UK.ORCID 0000-0003-2519-1539
Alvin Richards-BelleDivision of Psychiatry, University College London, London, UK alvin.richards-belle.21@ucl.ac.uk.

Funding

Medical Research Council (UKRI), (NIHR) the National Institute for Health ResearchUK British Heart Foundation, Cancer Research UKWellcome TrustWellcome Trust 218497/Z/19/Z
6 · The paper itself

Abstract

backgroundMetformin is a pharmacological candidate to mitigate second-generation antipsychotic (SGA)-induced weight gain in patients diagnosed with severe mental illnesses (SMI).

objectiveTo determine the incidence, prevalence and demographic patterns of metformin co-prescription among patients diagnosed with SMI initiating SGAs. To estimate the impact of metformin co-prescription on weight over 2 years post-SGA initiation.

methodsA cohort study of patients diagnosed with SMI initiating aripiprazole, olanzapine, quetiapine or risperidone in 2005-2019 using primary care data from Clinical Practice Research Datalink. We estimated cumulative incidence and period prevalences of co-prescription and explored prescribing differences by demographic and clinical factors. We compared weight change among patients prescribed an SGA-only versus an SGA plus metformin, accounting for confounders using linear regression.

findingsAmong 26 537 patients initiating SGAs, 4652 were ever prescribed metformin and 21 885 were not. The two-year incidence of first metformin prescription was 3.3%. The SGA plus metformin group were more ethnically diverse, had greater social deprivation, more comorbidities and higher baseline weight (mean 90.4 vs 76.8 kg). By 2 years post-SGA initiation, mean weight in the SGA-only group had changed by +4.16% (95% CI -1.26 to +9.58) compared with -0.65% (95% CI -4.26 to +2.96) in the SGA plus metformin group. After confounder adjustment, the 2-year mean difference in weight with metformin co-prescription was -1.48 kg (95% CI -4.03 to 1.07) among females and -1.84 kg (95% CI -4.67 to 0.98) among males.

conclusionMetformin is infrequently co-prescribed, despite apparent efficacy and guidelines. CLINICAL IMPLICATIONS: Primary and secondary care collaboration should be strengthened and barriers to co-prescribing addressed.

Indexed as

Antipsychotic AgentsHypoglycemic AgentsMental DisordersMetforminPractice Patterns, Physicians'Weight GainAdultCohort StudiesDrug PrescriptionsDrug Therapy, CombinationFemaleHumansMaleMiddle AgedPrimary Health CareUnited KingdomAntipsychotic AgentsHypoglycemic AgentsMetforminadult psychiatrydata interpretation, statisticalpsychiatryschizophrenia & psychotic disorders

Identifiers

PMID40175159
PMCPMC11966999

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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.