Metformin for Weight Loss and Control in Patients With Mood Disorder

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Two-thirds of patients in long-term treatment with a second-generation antipsychotic (SGA) experience weight gain. Weight gain might be due to receptor blockade to H₁ receptors (as with tricyclic antidepressants) and to 5-HT_2C receptors, impaired metabolic regulation, down-regulation of appetite suppression, and less physical activity due to sedation. Metformin promotes the decrease of glucose absorption, suppression of gluconeogenesis in liver, stimulation of glucose uptake in skeletal muscle, and augmentation of insulin activity.