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首页> 外文期刊>The annals of pharmacotherapy >Efficacy of metformin and topiramate in prevention and treatment of second-generation antipsychotic-induced weight gain.
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Efficacy of metformin and topiramate in prevention and treatment of second-generation antipsychotic-induced weight gain.

机译：二甲双胍和托吡酯在预防和治疗第二代抗精神病药物引起的体重增加中的功效。

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OBJECTIVE: To review the literature describing the efficacy of metformin and topiramate for the treatment of second-generation antipsychotic-induced weight gain. DATA SOURCES: Articles were identified by searching the MEDLINE database (from 1949 through January 2010) using the key words metformin, topiramate, antipsychotic, weight, weight gain, and obesity. STUDY SELECTION AND DATA EXTRACTION: All randomized, placebo-controlled trials of metformin and topiramate were selected for review. DATA SYNTHESIS: Weight gain due to second-generation antipsychotic use is a concern due to the risk of long-term metabolic and cardiovascular effects with these agents. These effects include obesity, hyperglycemia, and insulin resistance, all of which may contribute to diabetes and cardiovascular disease. Second-generation antipsychotics vary in the degree to which they cause weight gain, and dietary and lifestyle changes may not be feasible or sufficient in counter-acting this weight gain. Although other pharmacologic agents may be beneficial to prevent and treat antipsychotic-induced weight gain, metformin and topiramate have been the most extensively studied in this setting. Metformin acts peripherally to cause weight loss, while topiramate acts centrally. Review of 11 randomized, controlled trials demonstrates beneficial effects of metformin and topiramate in prevention and treatment of weight gain. Metformin is generally well tolerated and has been studied in pediatric patients, while topiramate is associated with more drug interactions and may possibly interfere with control of schizophrenia. CONCLUSIONS: Data for the use of metformin and topiramate in the treatment and prevention of second-generation antipsychotic-induced weight gain are limited. Both may be effective in helping patients lose weight via mechanisms that have yet to be clearly defined. The use of metformin results in greater weight loss than topiramate, and topiramate is associated with more risks and may compromise the treatment of schizophrenia. Treatment of antipsychotic-induced weight gain with metformin may be an option after lifestyle and dietary changes have failed.
机译：目的：回顾描述二甲双胍和托吡酯治疗第二代抗精神病药物引起的体重增加的疗效的文献。数据来源：通过检索MEDLINE数据库（从1949年到2010年1月），使用关键词二甲双胍，托吡酯，抗精神病药，体重，体重增加和肥胖症来鉴定文章。研究选择和数据提取：选择所有二甲双胍和托吡酯的随机，安慰剂对照试验进行审查。数据综合：使用第二代抗精神病药引起的体重增加是一个问题，因为这些药物可能会长期代谢和心血管。这些影响包括肥胖，高血糖症和胰岛素抵抗，所有这些都可能导致糖尿病和心血管疾病。第二代抗精神病药引起体重增加的程度各不相同，饮食和生活方式的改变可能无法或不足以抵消体重增加。尽管其他药物可能有益于预防和治疗抗精神病药物引起的体重增加，但二甲双胍和托吡酯在这种情况下得到了最广泛的研究。二甲双胍在外周起作用以引起体重减轻，而托吡酯则在中央起作用。对11项随机对照试验的回顾表明，二甲双胍和托吡酯在预防和治疗体重增加方面具有有益作用。二甲双胍通常具有良好的耐受性，并且已在儿科患者中进行了研究，而托吡酯与更多的药物相互作用相关，可能会干扰精神分裂症的控制。结论：二甲双胍和托吡酯用于治疗和预防第二代抗精神病药引起的体重增加的数据有限。两者都可能通过尚未明确定义的机制有效帮助患者减轻体重。与托吡酯相比，二甲双胍的减肥效果更大，并且托吡酯的风险更高，并且可能损害精神分裂症的治疗。生活方式和饮食改变失败后，用二甲双胍治疗抗精神病药物引起的体重增加可能是一种选择。

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