Mood Emot 2024 Mar; 22(1): 1-9   https://doi.org/10.35986/me.2024.22.1.1
Comparison of the Safety and Weight Loss Efficacy of Metformin and Liraglutide in Psychiatric Outpatients at a University Hospital: A Retrospective Chart Review
Mansuk Seo, MD1 , Won-Seok Choi, MD, PhD2 , Young Sup Woo, MD, PhD2 , Won-Myong Bahk, MD, PhD2
1Mapo St. Mary’s Psychiatric Clinic, 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Won-Myong Bahk, MD, PhD
Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea
TEL +82-2-3779-1051 FAX +82-2-761-8497 E-mail wmbahk@catholic.ac.kr ORCID https://orcid.org/0000-0002-0156-2510
Young Sup Woo, MD, PhD
Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea
TEL +82-2-3779-1139 FAX +82-2-780-6577 E-mail youngwoo@catholic.ac.kr ORCID https://orcid.org/0000-0002-0961-838X
Received: December 22, 2023; Revised: January 15, 2024; Accepted: January 27, 2024; Published online: March 31, 2024.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Metformin (MET) has been used to prevent weight gain in patients treated with antipsychotic drugs. However, liraglutide (LIRA), initially used for diabetes, is now considered for obesity treatment. The aim of this study was to investigate the effectiveness and safety of these drugs in patients with psychiatric disorders.
Methods: A retrospective chart review was performed on patients prescribed and administered MET and LIRA from January 1, 2017 to August 31, 2023. To assess treatment efficacy, the mean change in the body mass index of the patients before and after drug use was calculated for both medications. Drug safety was evaluated by determining the early discontinuation and occurrence of adverse effects.
Results: We collected data from 45 patients, with the majority being women (84.4%). The most frequently diagnosed psychiatric disorders were depressive disorder for LIRA (35.3%) and psychotic disorder for MET (63.6%). No demographic variations were observed between patients who were administered the two types of drugs. The treatment efficacy and safety of both drugs did not show any statistically significant difference. When conducting a subgroup analysis exclusively on patients diagnosed with psychotic disorders (n = 14), MET showed better efficacy; however, no statistically significant difference was observed (−2.48±3.17 vs. 0.56±2.93, t=−1.860, p=0.088).
Conclusion: LIRA and MET did not show any significant differences in terms of therapeutic efficacy and safety. However, in patients diagnosed with psychotic disorders, MET showed better efficacy and was cost-effective than LIRA. Future studies with larger sample sizes are required to confirm these findings.
Keywords: Metformin; Liraglutide; Psychiatric disorder; Efficacy; Safety

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