{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:15:11Z","timestamp":1777493711472,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Mixed dopamine and serotonin receptor antagonists (DSRAs) are associated with significant weight gain and its complications. Our aim was to evaluate the effectiveness of metformin in reducing body mass index (BMI) and metabolic parameters in children treated with DSRAs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We report a naturalistic study of 49 children and adolescents (mean age 14.9\u2009\u00b1\u20093.7 years), with BMI &gt;85 percentile for age, treated with DSRAs during 2018\u20132020 in a child psychiatry clinic. Clinical data, anthropometric measurements, and laboratory tests were compared between those who were (study group,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200931) and were not (control group,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200918) treated with metformin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean study duration was 9.7\u2009\u00b1\u20095.9 months. The BMI standard deviation scores (BMI-SDS) of the study group declined significantly (from 2.08\u2009\u00b1\u20090.40 to 1.81\u2009\u00b1\u20090.54,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while the BMI-SDS of the control group did not change (from 2.03\u2009\u00b1\u20090.45 to 2.04\u2009\u00b1\u20090.47,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.838). In the study group, the decline in the delta BMI-SDS\/month was more robust among those with good than poor adherence to metformin (\u22120.047\u2009\u00b1\u20090.039 vs. \u22120.004\u2009\u00b1\u20090.017,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003). The decrease in BMI-SDS was greater for patients treated with risperidone and clothiapine than with other DSRAs. Fasting insulin and insulin resistance index (homeostasis model assessment of insulin resistance [HOMA-IR]) declined in the study group (from 25.4\u2009\u00b1\u200913.8 to 19.9\u2009\u00b1\u200910.7,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.033 and from 5.4\u2009\u00b1\u20092.7 to 4.2\u2009\u00b1\u20092.1,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.028, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Metformin treatment was associated with significant decreases in BMI, fasting insulin, and HOMA-IR. The effect of metformin seems to be dependent on adherence and type of DSRAs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2021.0006","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T17:23:48Z","timestamp":1619112228000},"page":"376-380","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effectiveness of Metformin for Weight Reduction in Children and Adolescents Treated with Mixed Dopamine and Serotonin Receptor Antagonists: A Naturalistic Cohort Study"],"prefix":"10.1177","volume":"31","author":[{"given":"Yael","family":"Levy-Shraga","sequence":"first","affiliation":[{"name":"Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel."},{"name":"The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee Rima","family":"Madi","sequence":"additional","affiliation":[{"name":"The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mor","family":"Shalev","sequence":"additional","affiliation":[{"name":"The Division of Child and Adolescent Psychiatry, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kineret","family":"Mazor-Aronovitch","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel."},{"name":"The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Schwartz-Lifshitz","sequence":"additional","affiliation":[{"name":"The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel."},{"name":"The Division of Child and Adolescent Psychiatry, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doron","family":"Gothelf","sequence":"additional","affiliation":[{"name":"The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel."},{"name":"The Division of Child and Adolescent Psychiatry, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel."},{"name":"The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders 5th ed. Washington DC: American Psychiatric Association; 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.1232"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.15386\/mpr-1201"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0094112"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.11m07246"},{"key":"e_1_3_2_7_1","first-page":"69","article-title":"Metformin add-on vs","volume":"19","author":"Correll CU","year":"2020","unstructured":"Correll CU, , Sikich L, , Reeves G, , Johnson J, , Keeton C, , Spanos M, , Kapoor S, , Bussell K, , Miller L, , Chandrasekhar T, , Sheridan EM, , Pirmohamed S, , Reinblatt SP, , Alderman C, , Scheer A, , Borner I, , Bethea TC, , Edwards S, , Hamer RM, , Riddle MA: 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. 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