Getting to know metformin is one way child and adolescent psychiatrists can be more prepared to address metabolic side effects of atypical antipsychotic medications.
Metformin (Trade names: Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet)
Metformin is first-line treatment for overweight patients with Type II diabetes and is FDA approved for diabetic children age 10 and older. Metformin improves sensitivity to insulin and limits the production of glucose in the liver. Typical pediatric dosing of metformin starts at 500 mg per day for the first week with increases to a maximum dose of 1000 mg twice a day. Modest weight loss can occur in overweight youth at risk for diabetes (Park MH et al Diabetes Care 2009;32:1743-1745). Typical side effects of metformin include nausea, vomiting, gas, bloating, diarrhea, and loss of appetite.