MedicalResearch.com Interview with:
Evdokia Anagnostou MD
Canada Research Chair (Tier II) in Translational Therapeutics in Autism
Senior Clinician Scientist and co-lead of the Autism Research Centre
Holland Bloorview Kids Rehabilitation Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Researchers from Holland Bloorview Kids Rehabilitation Hospital / University of Toronto (Canada), Ohio State University, University of Pittsburgh, Columbia University, and Vanderbilt University, led a double-blind, placebo-controlled randomized clinical trial to examine whether metformin, a common type-2 diabetes drug, may be effective in counteracting weight gain commonly seen with the use of atypical antipsychotic medications, indicated by the FDA for the treatment of irritability in children and youth with autism spectrum disorder (ASD).
Results showed that metformin was effective in helping overweight children and adolescents with autism spectrum disorder (ASD) who take antipsychotic medications lower their body mass index (BMI).
Both FDA-approved antipsychotic medications for treating irritability and agitation symptoms in children and adolescents with ASD can cause a significant increase in weight gain, which in addition to increasing BMI, enhances long-term risk of diabetes. This complicates an already challenging issue as adolescents with autism spectrum disorder are ~ two times more likely to be obese than adolescents without developmental disabilities. Findings of this research are important, especially for families of children with ASD, as managing long-term physical health while also treating irritability/agitation symptoms, can help ensure that their child can participate fully in life (school, etc.).
MedicalResearch.com: What should readers take away from your report?
Response: It is critically important that we investigate new ways to support healthy outcomes as early as possible for those who are on these medications. Use of antipsychotics to help manage irritability associated with autism spectrum disorder can sometimes be long-term which means we need to provide families with solutions that support lasting optimal health in their children. The study suggests that the addition of metformin is one such strategy as it stops weight gain commonly seen with these medications.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The study suggests that physicians who treat children with autism spectrum disorder with atypical antipsychotics for severe irritability/aggression may now consider using metformin if significant weight gain is observed. The study however did not examine whether the addition of metformin at the onset of prescribing atypical antipsychotics would prevent weight gain altogether, and this remains an area for future research.
MedicalResearch.com: Is there anything else you would like to add?
Response: This study focused on an intervention to maintain good physical health for children whose mental health needs require medications with significant side effects.
Evidence for improvement in overall outcomes in children with autism spectrum disorder currently support intensive early intervention and several studies are exploring very early interventions for infants and toddlers before the diagnosis is even made.
There has also been significant investment in discovering medications that treat the core symptoms of ASD, as well as comorbidities such as anxiety and sleep disturbance in children and youth with autism spectrum disorder, in addition to supporting long term health. Several such studies are ongoing (e.g. tideglusib for core symptoms of ASD and oxytocin for social function. Information on ongoing autism research at Holland Bloorview Kids Rehabilitation Hospital can be seen at www.autismresearchcentre.ca
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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