Adjunctive metformin for antipsychotic-induced hyperprolactinemia: A systematic review

Medications
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Highlights

•Systematic metformin review for antipsychotic-induced hyperprolactinemia.
•Included three trials with a total of 325 patients.
•One randomized clinical trial and two observational studies.
•The quality of evidence ranged from “very low” to “moderate”.
•Metformin patients had a significant decrease in serum prolactin level.

Abstract

This systematic review examines adjunctive metformin therapy for the treatment of antipsychotic-induced hyperprolactinemia. A computerized search of databases in Chinese and the international databases in English provided three trials with a total of 325 patients including one randomized clinical trial (RCT) and two observational studies (single-group, before-after design). A meta-analysis could not be conducted. The quality of evidence ranged from “very low” to “moderate”. Metformin patients had a significant decrease in serum prolactin level with a mean of 54.6 μg/l in the three trials. In the RCT, menstruation restarted in 67% of those with menstrual disturbances versus 5% in placebo. In one observational study, 91% of patients no longer had signs or symptoms of galactorrhea. In the RCT, adverse drug reactions (ADRs) occurred at similar incidence rates among metformin and placebo patients, except that no significant increases in nausea, insomnia and agitation occurred which were not associated with discontinuations. Our systematic review indicated that adjunctive metformin significantly lowered prolactin level and relieved prolactin-related symptoms in patients with antipsychotic-induced hyperprolactinemia. Future higher quality RCTs need to verify the currently available limited evidence based on three trials which suggest that adjunctive metformin may be used effectively and safely for antipsychotic-induced hyperprolactinemia.
Keywords:
Metabolic abnormalities, Prolactin, Weight gain

http://www.psy-journal.com/article/S0165-1781(16)30083-X/abstract

3 Likes
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Hey. Thanx for this news. I struggled with sulpiride and hyperprolactinemia. Now , I want to try Solian (amisulpride) but I am scared of hyperprlactinemia. Maybe metformin will help. I will ask my p-doc when I see her.

Best regards

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I take Metformin (Glucophage) and my Prolactin levels are only slightly elevated, maybe its working!

I do suffer from Hiigh Prolactin related side effects like low libido, etc…

Interesting stuff @firemonkey - Thanks!

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Hi Wave!
What antipsychotic are you taking? What dosage of Metformin do you take and for how long?

Best regards.

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Hi @petar_pan, I take 2.5 mg of Risperdal and am currently on 2000 mg of Metformin - I have been on Metformin for about 7 years or so.

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Thank you. Do you notice any side effect from Metformin ? Why were you prescribed metformin? Who prescribed it to you? Your psychiatrist? Sorry I have some many questions but it seems metformin could work with amisulpride and my condition could improve.

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I dont have any side effects from taking Metformin - in the begining, maybe some stomach discomfort (mild for me).

My last GP - family doctor prescribed it to me for Diabetes - High Blood Sugar.

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There may be more benefits to metformin:

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