Health In Focus
  • Autism affects tens of millions of children worldwide
  • Antipsychotic drugs are prescribed to treat irritability, but it increases food craving
  • Type 2 diabetes drug metformin may help maintain or reduce body mass index

Metformin a common drug used to treat type 2 diabetes can also be effective to reduce weight in children and adolescents with autism spectrum disorder (ASD). Children with autism are prescribed antipsychotic drugs to treat irritability and agitation. This increases food craving and results in excessive food intake, contributing to weight gain. A new study claims that diabetes drug metformin can help maintain or reduce body mass index of children with autism.

Impact of Metformin on Body Mass Index
Diabetes Drug Metformin Decreases Weight Gain in Children With Autism
Diabetes Drug Metformin Decreases Weight Gain in Children With Autism

Studies have shown that adolescents with autism are more likely to be overweight than those without developmental disabilities. Antipsychotic medications risperidone and aripiprazole are the drugs the U. S. Food and Drug Administration has approved for use in autism. Long-term use of antipsychotic medications increases weight gain and BMI, increasing the risk of diabetes.

The researchers investigated the effectiveness of commonly used diabetes drug, metformin, in counteracting the weight gain associated with antipsychotics. A team of researchers from The Ohio State University, University of Toronto, University of Pittsburgh, Vanderbilt University, Massachusetts General Hospital and Harvard Medical School conducted a double-blinded randomized clinical trial in children and adolescents with autism.

The clinical trial involved 60 children and adolescents between the ages of 6-17 with autism. The participants were overweight due to side effects of antipsychotic drugs prescribed to treat irritability and side effects. The participants were given metformin drug for 16 weeks. The results showed that metformin significantly reduced BMI scores of the participants than those in the placebo group.

"This is a very special group, as young people with ASD present with many unique challenges. By definition, they experience communication difficulties, and they're reported to have more gastrointestinal (GI) difficulties than most other patient groups," said Michael Aman, professor emeritus of psychology at The Ohio State University Wexner Medical Center's Nisonger Center and lead investigator at Ohio State.

"It's critically important that we investigate new ways to support healthy outcomes as early as possible for those who are on antipsychotic medications. Use of antipsychotics to help manage irritability associated with ASD can sometimes be long­term, which means we need to provide families with solutions that support lasting optimal health in their children," said Dr. Evdokia Anagnostou, principal investigator of the study and senior clinician scientist and co­lead of Holland Bloorview Kids Rehabilitation Hospital's Autism Research Centre.

Children who were prescribed the drug metformin were able to maintain their treatment compared to placebo group. The researchers observed that metformin did not cause any behavioral changes, such as increased irritability, said Aman.

Only a few studies have examined treatment and prevention of weight gain in children and adolescents with autism. Researchers note that the results of the current study are promising in terms of weight management.

"Food selection commonly associated with autism adds to the challenge of weight management. It's not the amount that's eaten, rather the food choices that are a by­product of the cravings and linked to weight gain," said Aman. The study is published in the Journal of the American Medical Association Psychiatry.

Autism is a complex disorder of the brain development. The condition is characterized by difficulties in social interaction, verbal and non-verbal communication and repetitive behaviors. Autism affects tens of millions of children worldwide. In the last few years, the prevalence rates of autism have increased by 10 to 17 percent every year. According to the statistics of the US Centers for Disease Control and Prevention (CDC), one in 68 children is likely to be diagnosed with autism. This neurodevelopmental disorder is four times more common among boys than girls.

Antipsychotic Drugs for Autism

Antipsychotic drugs are used to treat a variety of symptoms in autism such as irritability, hyperactivity, aggression, and self-injury. Chlorpromazine, trifluoperazine, thiothixene, trifluperidol, fluphenazine and molindone are some of the antipsychotic drugs. One of the most troublesome side effect of antipsychotics is weight gain. Antipsychotic drugs induce weight gain due to changes in appetite and weight gain. Excessive weight gain can lead to the development of diabetes, cardiovascular diseases, and hyperlipidemia (elevated levels of cholesterol). Some of the other side effects of antipsychotic drugs include constipation, dry mouth, and muscle stiffness.

The study concludes that diabetes drug, metformin can be prescribed for young children with autism along with antipsychotic drugs. Metformin can significantly lower BMI scores and prevent the risk of developing obesity-related diseases.

Source: Medindia

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