{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:18:45Z","timestamp":1789543125679,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T00:00:00Z","timestamp":1656115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000241","name":"Physicians' Services Incorporated Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000241","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Clozapine is presently the sole antipsychotic with an indication for treatment\u2010resistant Schizophrenia, but is associated with significant weight gain and other metabolic aberrations. This retrospective chart review aimed to evaluate the effectiveness of adjunctive metformin in preventing clozapine\u2010induced weight gain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective chart review of patients newly initiated on clozapine at the Centre for Addiction and Mental Health in Canada, from November 2014 to April 2021. Our primary outcome was body weight at 6 and 12\u2009months after clozapine initiation. Other metabolic parameters served as secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 396 patients (males: 71.5%, mean age: 42.8\u2009years) initiated on clozapine, 69 were on metformin or prescribed it \u22643\u00a0months after clozapine initiation. The clozapine+metformin group demonstrated less weight gain compared with the clozapine\u2010only group at 6\u00a0months (clozapine+metformin: \u22120.15\u2009kg [SE\u00a0=\u00a01.08] vs. clozapine\u2010only: 2.99\u2009kg, SE\u00a0=\u00a00.54) and 12\u2009months after clozapine initiation (clozapine+metformin: \u22120.67\u2009kg, SE\u00a0=\u00a01.22 vs. clozapine\u2010only: 4.72\u2009kg, SE\u00a0=\u00a00.67). Adaptive changes were also observed for fasting glucose (\n                      <jats:italic>F<\/jats:italic>\n                      \u00a0=\u00a03.10,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.046) and triglycerides (\n                      <jats:italic>F<\/jats:italic>\n                      \u00a0=\u00a08.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) in the clozapine+metformin group compared with clozapine only.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large retrospective naturalistic cohort study, co\u2010prescription of clozapine and metformin was associated with less weight gain and related metabolic dysfunction at 6 and 12\u2009months after initiation versus clozapine alone. These findings provide evidence for the effectiveness of metformin in preventing clozapine\u2010induced weight gain; larger randomized controlled trials are needed to confirm these results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13462","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T23:48:56Z","timestamp":1655768936000},"page":"190-200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Metformin for the prevention of clozapine\u2010induced weight gain: A retrospective naturalistic cohort study"],"prefix":"10.1111","volume":"146","author":[{"given":"Nicolette","family":"Stogios","sequence":"first","affiliation":[{"name":"Schizophrenia Division Centre for Addiction and Mental Health (CAMH)  Toronto Canada"},{"name":"Temerty Faculty of Medicine, Institute of Medical Science University of Toronto  Toronto 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 Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Gerretsen","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, Institute of Medical Science University of Toronto  Toronto Canada"},{"name":"Multimodal Imaging Group Research Imaging Centre, Centre for Addiction and Mental Health (CAMH)  Toronto Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Graff\u2010Guerrero","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, Institute of Medical Science University of Toronto  Toronto Canada"},{"name":"Multimodal Imaging Group Research Imaging Centre, Centre for Addiction and Mental Health (CAMH)  Toronto Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araba F.","family":"Chintoh","sequence":"additional","affiliation":[{"name":"Schizophrenia Division Centre for Addiction and Mental Health (CAMH)  Toronto Canada"},{"name":"Temerty Faculty of Medicine, Institute of Medical Science University of Toronto  Toronto Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Foussias","sequence":"additional","affiliation":[{"name":"Schizophrenia Division Centre for Addiction and Mental Health (CAMH)  Toronto Canada"},{"name":"Temerty Faculty of Medicine, Institute of Medical Science University of Toronto  Toronto Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9433-9416","authenticated-orcid":false,"given":"Gary","family":"Remington","sequence":"additional","affiliation":[{"name":"Schizophrenia Division Centre for 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