https://search.dev.ndltd.org/etd/milano/oai:air.unimi.it:2434/1119675
type: CreativeWork
name: THE ROLE OF HYPOGLYCEMIC AGENTS IN AMELIORATING COGNITIVE FUNCTIONS AND PSYCHIATRIC SYMPTOMS: FROM THE PSYCHIATRIC PATIENT TO EVIDENCE-BASED AND PHARMACOEPIDEMIOLOGIC APPROACHES FOR SUPPORTING THE CLINICAL PRACTICE
description: Background: Research highlights a complex link between diabetes-related factors such as insulin resistance, hyperglycemia, and chronic inflammation, all contributing to cognitive decline. Schizophrenia and depression, which often co-occur with type 2 diabetes mellitus, show a bidirectional relationship with diabetes, involving both brain and systemic responses. Antidiabetic drugs such as metformin and drug targeting Glucagon-Like Peptide-1 (GLP-1) are being proposed for psychiatric and cognitive treatments, although their use for non-diabetic purposes remains debated. Methods: The role of antidiabetic drugs in ameliorating psychiatric and cognitive functions was explored across various real-world settings where these drugs are already used for glycemic control. A meta-analysis and meta-regression were conducted to study metformin in schizophrenic patients. Innovative approaches regarding disproportionality analysis of concomitant therapies in pharmacovigilance databases were used to explore all antidiabetic drugs (ATC code: A10) in combination with antidepressants. Survival analysis was performed using Danish healthcare registers to evaluate the potential benefits of GLP-1 analogues (GLP-1a) in older patients. Results: Metformin showed a positive trend without reaching strong statistical significance in ameliorating psychiatric symptoms in a meta-analysis of randomized controlled trials involving schizophrenic patients [SMD (95%CI) = -0.40 (-0.82;0.01), OR (95%CI) = 0.5 (-2.4;3.4)] and reducing the reporting risk of therapy failure in depressive patients [ROR95=1.14, PPR(p)= 1.07 (0.00), EBGM95=0.96 ERAM95=0.89 in FAERS and ROR95=1.48 PPR(p)= 1.34 (0.00) EBGM95=1.22 and ERAM95=0.86 in VigiBase]. GLP-1a and DPP-4 inhibitors (DPP-4i) resulted in better outcomes with a preference for GLP-1a for reducing the risk of major cognitive impairment (dementia) in old diabetic patients [aHR (95% CI) = 1.5 (1.16-2.04), p = 0.003 for DPP-4i compared to GLP1-a (reference group)]. …
abstract: Background: Research highlights a complex link between diabetes-related factors such as insulin resistance, hyperglycemia, and chronic inflammation, all contributing to cognitive decline. Schizophrenia and depression, which often co-occur with type 2 diabetes mellitus, show a bidirectional relationship with diabetes, involving both brain and systemic responses. Antidiabetic drugs such as metformin and drug targeting Glucagon-Like Peptide-1 (GLP-1) are being proposed for psychiatric and cognitive treatments, although their use for non-diabetic purposes remains debated. Methods: The role of antidiabetic drugs in ameliorating psychiatric and cognitive functions was explored across various real-world settings where these drugs are already used for glycemic control. A meta-analysis and meta-regression were conducted to study metformin in schizophrenic patients. Innovative approaches regarding disproportionality analysis of concomitant therapies in pharmacovigilance databases were used to explore all antidiabetic drugs (ATC code: A10) in combination with antidepressants. Survival analysis was performed using Danish healthcare registers to evaluate the potential benefits of GLP-1 analogues (GLP-1a) in older patients. Results: Metformin showed a positive trend without reaching strong statistical significance in ameliorating psychiatric symptoms in a meta-analysis of randomized controlled trials involving schizophrenic patients [SMD (95%CI) = -0.40 (-0.82;0.01), OR (95%CI) = 0.5 (-2.4;3.4)] and reducing the reporting risk of therapy failure in depressive patients [ROR95=1.14, PPR(p)= 1.07 (0.00), EBGM95=0.96 ERAM95=0.89 in FAERS and ROR95=1.48 PPR(p)= 1.34 (0.00) EBGM95=1.22 and ERAM95=0.86 in VigiBase]. GLP-1a and DPP-4 inhibitors (DPP-4i) resulted in better outcomes with a preference for GLP-1a for reducing the risk of major cognitive impairment (dementia) in old diabetic patients [aHR (95% CI) = 1.5 (1.16-2.04), p = 0.003 for DPP-4i compared to GLP1-a (reference group)]. …
author: BATTINI, VERA
language: eng
keywords: glucose-lowering agent, cognitive disfunction, drug repurposing, Settore BIOS-11/A - Farmacologia
date published: 2024-12-19
date modified: 2026-07-27T20:18:48Z
provider: Università degli Studi di Milano
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Università degli Studi di Milano

PropertyValue
property ID: Handle
value: https://hdl.handle.net/2434/1119675