Etudes sur la metformine

À partager avec votre professionnel de santé

Voici la liste des études pertinentes à partager pour l’utilisation de la metformine en tant que “coupe-faim”, chez les patients qui se plaignent d’une faim induite par les psychotropes, ou d’une prise de poids – voire les deux.

Je compte sur vous pour partager, il faut que ça tourne le plus possible. Je propose aux praticiens qui souhaitent critiquer ces papiers de m’envoyer directement un mail à msikorav.psychiatrie@outlook.com. Je répondrai aux critiques dans des vidéos.

Et je rappelle brièvement avant toute chose, que les psychiatres prescrivent du Tercian sans aucune étude randomisée dans ses indications depuis plusieurs décennies, sans que ça ne dérange personne.

C’est parti.

1) Études randomisées chez les adultes

Lifestyle Intervention and Metformin for Treatment of Antipsychotic-Induced Weight Gain: A Randomized Controlled Trial (Wu et al., 2008, JAMA)

Metformin Addition Attenuates Olanzapine-Induced Weight Gain in Drug-Naive First-Episode Schizophrenia Patients: A Double-Blind, Placebo-Controlled Study (Wu et al., 2008, AJP)

Metformin for Prevention of Weight Gain and Insulin Resistance with Olanzapine: A Double-Blind Placebo-Controlled Trial (Baptista et al., 2006)

Metformin as an Adjunctive Treatment to Control Body Weight and Metabolic Dysfunction During Olanzapine Administration: A Multicentric, Double-Blind, Placebo-Controlled Trial (Baptista et al., 2007)

Extended Release Metformin for Metabolic Control Assistance During Prolonged Clozapine Administration: A 14 Week, Double-Blind, Parallel Group, Placebo-Controlled Study (Carrizo et al., 2009)

Metformin for Treatment of Antipsychotic-Induced Weight Gain: A Randomized, Placebo-Controlled Study (Wang et al., 2012)

Metformin for Treatment of Antipsychotic-Induced Amenorrhea and Weight Gain in Women With First-Episode Schizophrenia: A Double-Blind, Randomized, Placebo-Controlled Study (Wu et al., 2012)

Metformin for Weight Loss and Metabolic Control in Overweight Outpatients With Schizophrenia and Schizoaffective Disorder (Jarskog et al., 2013)

Twenty-Four Week, Randomized, Double-Blind, Placebo-Controlled Trial of Metformin for Antipsychotic-Induced Weight Gain in Patients With First-Episode Psychosis: A Pilot Study (Tang et al., 2022)

Bien sûr, on préfère toujours des méta-analyses à quelques études prises par-ci par-là. Heureusement, on en a !

2) Méta-analyses chez l’adulte

Metformin in Prevention and Treatment of Antipsychotic Induced Weight Gain: A Systematic Review and Meta-Analysis (Da Silva et al., 2016)

Metformin for Clozapine Associated Obesity: A Systematic Review and Meta-Analysis (Siskind et al., 2016)

Pharmacological Interventions for Prevention of Weight Gain in People With Schizophrenia (Une revue Cochrane)

Metformin Co-Commencement at Time of Antipsychotic Initiation for Attenuation of Weight Gain: A Systematic Review and Meta-Analysis (Yu et al., 2024)

The Optimal Dosage and Duration of Metformin for Prevention and Treatment of Antipsychotic-Induced Weight Gain: An Updated Systematic Review and Meta-Analysis (Pent et al., 2025)

Et le meilleur pour la fin :

3) Guidelines

Metformin in the management of antipsychotic-induced weight gain in adults with psychosis: development of the first evidence-based guideline using GRADE methodology (Fitgerald et al., 2022)

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders (Galetly et al., 2016)

Metformin for the Prevention of Antipsychotic-Induced Weight Gain: Guideline Development and Consensus Validation (Carolan et al., 2025)

Ces recommandations méritent d’être lues. Les auteurs proposent de commencer la metformine de façon conjointe systématiquement quand on instaure de la clozapine, olanzapine, et chez les patients avec des facteurs de risque cardio-métaboliques ou âgés de 10 à 25 ans quand on instaure la quétiapine, la palipéridone, ou la risperidone.

Quel que soit l’antipsychotique, ils recommandent d’instaurer la metformine si la prise de poids est supérieure à 3% de la masse corporelle au cours de la première année. Ça fait beaucoup de monde !

Mais il nous manque encore les mineurs. Est-ce qu’on a des études dans cette population ? Oui !

4) Etudes chez les enfants et les adolescents (randomisées ou non)

Metformin for Weight Loss in Pediatric Patients Taking Psychotropic Drugs (Morrison et al., 2002)

A Randomized, Double-Blind, Placebo-Controlled Trial of Metformin Treatment of Weight Gain Associated With Initiation of Atypical Antipsychotic Therapy in Children and Adolescents (Klein et al., 2006)

Metformin for Weight Control in Pediatric Patients on Atypical Antipsychotic Medication (Shin et al., 2009)

Metformin for Treatment of Overweight Induced by Atypical Antipsychotic Medication in Young People With Autism Spectrum Disorder: A Randomized Clinical Trial (Anagnostou et al., 2016)

Metformin Add-On vs. Antipsychotic Switch vs. Continued Antipsychotic Treatment Plus Healthy Lifestyle Education in Overweight or Obese Youth With Severe Mental Illness: Results From the IMPACT Trial (Corell et al., 2020)

Metformin for Overweight and Obese Children and Adolescents With Bipolar Spectrum and Related Mood Disorders Treated With Second-Generation Antipsychotics: A Randomised, Pragmatic Trial (DelBello et al., 2025)

The Effectiveness of Metformin in Managing Second Generation Antipsychotic-Induced Weight Gain in Children and Adolescents (Chen et al., 2024)

5) Méta-analyses chez les enfants et les adolescents

Metformin for Weight Gain Associated With Second-Generation Antipsychotics in Children and Adolescents: A Systematic Review and Meta-Analysis (Ellul et al., 2018)

The Role of Metformin in Treatment of Weight Gain Associated With Second-Generation Antipsychotic Use in Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (Mansuri et al., 2022)

Voilà, vous avez suffisamment d’arguments.

Partagez le plus possible !

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