{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:22:36Z","timestamp":1784524956341,"version":"3.55.0"},"reference-count":56,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001786","name":"University of Adelaide","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001786","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":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metformin shows potential in combating clozapine\u2010induced weight gain (CIWG). However, current evidence for its use remains limited. Through an audit we determined the prevalence of metformin use among clozapine\u2010treated patients and its impact on weight and waist circumference (WC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study examined electronic medical records of community\u2010based clozapine patients under the care of metropolitan community mental health teams within the Central Adelaide Local Health Network (CALHN) from January 2014 to June 2023. We included patients treated with clozapine both with and without metformin, above 18\u2009years of age, with complete physical monitoring data at baseline, 6, and 12\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 357 patients, who met study criteria. Metformin was prescribed to 23% of patients, of whom 78% had diabetes. At baseline, WC was &gt;\u2009101\u2009cm in 71% of males and &gt;\u200987\u2009cm in 86% of females, placing them at increased risk of weight\u2010related comorbidities, including cardiovascular disease, cancer, and death. After 1\u2009year, males and females in the highest risk group for WC\u2010related comorbidities increased to 76.3% and 95.4%, respectively. Co\u2010prescription of metformin with clozapine was associated with unadjusted mean weight loss (\u22121.67\u2009kg) and decrease in WC (\u22121.00\u2009cm). Patients not using metformin gained weight (0.68\u2009kg) and WC (2.49\u2009cm). Using a linear mixed\u2010effects models adjusting for repeated measurements, age, sex, and type 2 diabetes, over 12\u2009months, patients treated with metformin were 3.08\u2009kg lighter than those not taking metformin (95% confidence interval [CI]: 0.54\u20135.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Similar models suggested patients treated with metformin showed an average 2.83\u2009cm decrease in WC compared with those not taking metformin (CI: 0.26\u20135.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). There was no significant interaction between difference from baseline in weight or WC and metformin dose (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion\/Conclusion<\/jats:title>\n                    <jats:p>The prevalence of metformin use for CIWG appears low in this cohort, where over 84% of patients were overweight or obese. Metformin use was associated with a significantly lower incidence of weight and WC gain over 12\u2009months. Pharmacists are crucial for educating clinicians and patients about the benefits of metformin for reducing CIWG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13796","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T18:47:41Z","timestamp":1741718861000},"page":"719-730","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Metformin on Weight and Waist Circumference in Patients Treated With Clozapine: A One\u2010Year Retrospective Cohort Study"],"prefix":"10.1111","volume":"151","author":[{"given":"Bee Leng","family":"Per","sequence":"first","affiliation":[{"name":"Central Adelaide Local Health Network  Adelaide South Australia Australia"},{"name":"SA Pharmacy Central Adelaide Local Health Network  Adelaide South Australia 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Adelaide South Australia Australia"},{"name":"Office of the Chief Psychiatrist  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1640-5611","authenticated-orcid":false,"given":"Scott Richard","family":"Clark","sequence":"additional","affiliation":[{"name":"Central Adelaide Local Health Network  Adelaide South Australia Australia"},{"name":"Basil Hetzel Institute  Woodville South Australia"},{"name":"Discipline of Psychiatry University of Adelaide  Adelaide South Australia 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