Aim

To evaluate the efficacy and safety of berberine as an adjuvant in treating antipsychotic-associated weight gain and metabolic syndrome (MetS).

Methods

One hundred and thirteen participants with schizophrenia spectrum disorders who had developed MetS were recruited. They were randomly assigned to berberine (600 mg/day, n=58) or placebo (n=55) groups for 12 weeks. The primary outcome was the change from baseline to week 12 in net weight. Secondary outcomes included body mass index (BMI), waist circumference, serum glucose and lipid profiles, and the severity of psychotic symptoms.

Results

Compared with the placebo group, the berberine group showed a significantly greater reduction in weight gain at 9 weeks (mean difference [MD]=-0.75, 95% confidence interval [CI]: -1.42 to -0.07, P=0.031, d=0.41) and 12 weeks (MD=-1.08, 95% CI: -1.76 to -0.40, P=0.002, d=0.59). Patients who received berberine also showed statistically significant improvements in endpoint in BMI (MD=-0.41, 95% CI: -0.65 to -0.17, P=0.001, d=0.64), total cholesterol (MD=-0.58, 95% CI: -0.74 to -0.41, P<.001, d=1.31), low-density lipoprotein (MD=-0.52, 95% CI: -0.68 to -0.35, P<.001, d=1.19), and glycated hemoglobin (MD=-0.09, 95% CI: -0.18 to 0, P=0.05, d=0.37). Berberine was well tolerated without serious adverse events and aggravation of psychotic symptoms compared with placebo.

Conclusions

Findings suggest that berberine is effective in attenuating antipsychotic-associated weight gain and MetS.

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