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Letters to the Editor   |    
Metformin and Alzheimer’s Disease Risk
Jonathan E. Rosenfeld, M.D., Ph.D.
Am J Psychiatry 2014;171:119. doi:10.1176/appi.ajp.2013.13091193
View Author and Article Information

The author reports no financial relationships with commercial interests.

From the Department of Psychiatry, St. Luke’s-Roosevelt Hospital Center, and the Department of Psychiatry, Columbia University, New York.

Copyright © 2014 by the American Psychiatric Association

Accepted October , 2013.

To the Editor: In the September issue of the Journal, Jarskog et al. (1) report and Correll et al. (2) discuss a 4-month trial of metformin that concluded “metformin was modestly effective in reducing … risk factors for cardiovascular disease” and “represents a safe … option for patients who are motivated to lose weight.” That study spanned 4 months, but the treatment of cardiovascular risk factors may continue indefinitely. Imfeld et al. (3) reported that long-term metformin use (over 60 prescriptions or more than 7 years) but not use of other antidiabetic medications such as sulfonylureas, thiazolidinediones, or insulin was associated with a small increased risk of developing Alzheimer’s disease (adjusted odds ratio, 1.71).

I would be grateful if Jarskog et al. and Correll et al. would compare the benefit they anticipate from reducing cardiovascular risk factors with metformin in psychiatric, nondiabetic patients to the risk of increased Alzheimer’s disease from metformin.

Jarskog  LF;  Hamer  RM;  Catellier  DJ;  Stewart  DD;  Lavange  L;  Ray  N;  Golden  LH;  Lieberman  JA;  Stroup  TS; METS Investigators:  Metformin for weight loss and metabolic control in overweight outpatients with schizophrenia and schizoaffective disorder.  Am J Psychiatry 2013; 170:1032–1040
[CrossRef] | [PubMed]
 
Correll  CU;  Sikich  L;  Reeves  G;  Riddle  M:  Metformin for antipsychotic-related weight gain and metabolic abnormalities: when, for whom, and for how long? Am J Psychiatry 2013; 170:947–952
[CrossRef] | [PubMed]
 
Imfeld  P;  Bodmer  M;  Jick  SS;  Meier  CR:  Metformin, other antidiabetic drugs, and risk of Alzheimer’s disease: a population-based case-control study.  J Am Geriatr Soc 2012; 60:916–921
[CrossRef] | [PubMed]
 
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References

Jarskog  LF;  Hamer  RM;  Catellier  DJ;  Stewart  DD;  Lavange  L;  Ray  N;  Golden  LH;  Lieberman  JA;  Stroup  TS; METS Investigators:  Metformin for weight loss and metabolic control in overweight outpatients with schizophrenia and schizoaffective disorder.  Am J Psychiatry 2013; 170:1032–1040
[CrossRef] | [PubMed]
 
Correll  CU;  Sikich  L;  Reeves  G;  Riddle  M:  Metformin for antipsychotic-related weight gain and metabolic abnormalities: when, for whom, and for how long? Am J Psychiatry 2013; 170:947–952
[CrossRef] | [PubMed]
 
Imfeld  P;  Bodmer  M;  Jick  SS;  Meier  CR:  Metformin, other antidiabetic drugs, and risk of Alzheimer’s disease: a population-based case-control study.  J Am Geriatr Soc 2012; 60:916–921
[CrossRef] | [PubMed]
 
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