A new study suggests that the diabetes drug metformin hydrochloride may help prevent weight gain in autistic children on atypical antipsychotics.
The atypical antipsychotic drugs risperidone and aripiprazole are approved by the US.
Food and Drug Administration for autism spectrum disorder, as both medications improve irritability and agitation. But both tend to cause weight gain and can raise the risk of diabetes with long term use.
A research team based in Canada looked at the interactions between these drugs in a sample of 61 children and adolescents with autism aged six to 17 years. Participants randomly received metformin or placebo for 16 weeks.
Those on metformin showed a significantly reduced weight and body mass index compared with those on placebo. Among the 28 children in the metformin group, 11% saw declines of 8% to 9% in body mass index. However, no other participants showed falls of more than 5%.
"Overall, metformin was well tolerated," say the team, led by Dr Evdokia Anagnostou, of the Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada, in JAMA Psychiatry.
They conclude: "These findings have important implications for children in whom the benefits of atypical antipsychotics for treating irritability and agitation symptoms are difficult to balance with the substantial weight gain that often accompanies their use.
"Metformin may be effective in decreasing weight gain associated with atypical antipsychotic use and is well tolerated by children and adolescents with autistic spectrum disorder."
In an editorial, Dr Christopher McDougle, of Massachusetts General Hospital, USA, states: "Larger and longer-term studies of metformin administration in youths with autistic spectrum disorder treated with an atypical antipsychotic will be important to address these concerns and remaining questions."
Anagnostou, E. et al. Metformin for Treatment of Overweight Induced by Atypical Antipsychotic Medication in Young People With Autism Spectrum Disorder: A Randomized Clinical Trial. JAMA Psychiatry 24 August 2016; doi: 10.1001/jamapsychiatry.2016.1232
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