The Role Of Metformin In Treating Psychiatric Illnesses

Who would have thought that a diabetes drug could also be a long-sought solution to many psychiatric and neurodegenerative problems? And yet, that seems to be the case.

Researchers are now studying the use of metformin, a diabetes medicine, in psychiatry. Metformin typically works as a hypoglycemic agent in that it reduces blood sugar levels in diabetic patients. But did you know that metformin is also beneficial in several neurodegenerative and mental illnesses?

So far, studies have been able to show metformin’s effects in managing psychiatric issues like bipolar depression, antipsychotic-induced weight gain, and schizophrenia, and even anti-aging.

Let’s dissect.

Metformin For Antipsychotic-Induced Weight Gain

As patients are prescribed atypical antipsychotic medications, they may be faced with a daunting side-effect: weight gain. To counter that, psychiatrists may prescribe metformin alongside the antipsychotic drug. That’s because metformin works by reducing blood sugar levels and inducing insulin production, thereby reversing weight gain.

But why is this important? You see, metabolic dysregulation is pretty much common in patients with psychotic and mood disorders. Obesity and type 2 diabetes may also be present at the onset of the mental illness or may result from its treatment (using antipsychotics). This means blood sugar is higher, consequently leading to cardiovascular problems. And when cardiovascular problems coexist with a mental illness, the risk of early death skyrockets.

Thankfully, metformin provides a way to intervene in this dangerous cycle and help regulate metabolism, preventing the escalation of these problems. So, it’s not just the key to managing weight gain, but also a valuable tool in improving overall health outcomes for patients with psychiatric disorders.

Metformin Effective In Treating Depression

The role of metformin in depression is mind-blowing. Metformin helps in reducing depression and anxiety by increasing serotonin, the happiness hormone. Even more astounding, data suggests that women who take metformin may have a staggering 3.3 times lower risk of developing major depression.

Metformin In Treatment-Resistant Bipolar Depression

Type 2 diabetes and insulin resistance are prevalent in patients with bipolar disorder, and they usually worsen the symptoms. In some cases, the depressive side refuses to respond to treatment even when the manic symptoms improve.

Enter metformin.

Researchers have found that metformin improves depressive symptoms in bipolar disorder patients by combating insulin resistance. They couldn’t find any changes in the manic symptoms, though. But then, other medications can manage the mania, while metformin addresses the treatment-resistant depression. Perfect combo.

Find more on the research here.

The Role Of Metformin In Schizophrenia

Schizophrenia isn’t left out in the list of neuropsychiatric disorders that metformin can help with. Its effect here is very similar to that of bipolar depression.

Cardiovascular disease is the leading cause of death in patients with schizophrenia. Now, weight gain and metabolic dysfunction, precursors to cardiovascular diseases, are also common in schizophrenia patients because of the antipsychotic treatment. By reversing weight gain and insulin resistance, metformin can ward off cardiovascular problems and increase the life expectancy of schizophrenia patients. Isn’t that just amazing!

More on the research here.

It still didn’t end there. But I bet this will blow your mind. Diabetic patients on metformin have been showing signs of better cognitive function in old age that non-diabetic individuals now use the drug with hopes of staying youthful for longer. But it’s not mere observation. Extensive research shows that metformin can be used for anti-aging. Although it doesn’t rejuvenate skin or looks, metformin’s anti-aging effects are geared towards maintaining memory and cognitive function and preventing age-related cognitive decline.

None of the metformin-antiaging studies have been conducted on humans, but this is what the animal models show. Aging animals treated on metformin outperformed their counterparts in cognitive and memory tests. They also behaved more like younger animals – energetic.

Here’s what the scientists discovered. As the brain ages, microglia becomes activated due to neurodegeneration, and the hippocampus (responsible for memory formation) becomes inflamed. When the inflammation reaches a point, cognitive problems begin to manifest. Now, the brain of aging animals treated with metformin showed significantly reduced microglia activation and reduced inflammation in the hypocamus. In addition, the cells throughout their body showed better energy levels.

So even though metformin doesn’t make a 65-year old to look younger, their overall body function will remain like that of a 40 year old. Another level of anti-aging, if you ask me.

Metformin also enhances autophagy in the aging brain. Better autophagy alone is enough to prevent or slow down cognitive problems such as Alzheimer’s and Parkinson’s.

More on the research here.

The Bottom Line

All evidence suggests that metformin is nothing short of revolutionary in the world of medicine. One drug to manage Type 2 diabetes, heart diseases, mood disorders, weight gain, and age-related cognitive problems. This is big.

Moreoever, psychopharmacology is not evolving as quickly as other branches of medicine.

If metformin can show this much potential in managing certain mental health conditions, then we’ve gotten somewhere. It wouldn’t be surprising to see this diabetes drug being approved and repurposed for use in psychiatry in the near future.

Author

Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.