Metformin for Lithium-induced Weight Gain: A Case Report

Area of Science:

• Psychiatry
• Pharmacology
• Endocrinology

Background:

• Lithium is a primary treatment for bipolar disorder maintenance.
• Weight gain is a common long-term adverse effect of lithium therapy.
• No established guidelines exist for managing lithium-induced weight gain.

Purpose of the Study:

• To report a case of successful management of significant lithium-induced weight gain.
• To explore the potential role of metformin in treating this adverse effect.

Main Methods:

• A young male patient with bipolar disorder experienced substantial weight gain (25 kg) on lithium.
• Treatment with metformin at 500 mg twice daily was administered.
• Patient's weight response to metformin was monitored.

Main Results:

• The patient showed a positive response to metformin treatment, with weight reduction.
• Metformin was administered at a dosage of 500 mg twice daily.
• The treatment was effective in mitigating lithium-induced weight gain.

Conclusions:

• Metformin may be a viable option for managing lithium-induced weight gain in bipolar disorder patients.
• Proposed mechanisms involve hypothalamic changes, improved insulin sensitivity, and altered circadian rhythms affecting metabolism.
• Further research is warranted to confirm metformin's efficacy and safety for this indication.