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Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program

Authors AlHussain F, AlRuthia Y, Al-Mandeel H, Bellahwal A, Alharbi F, Almogbel Y, Awwad O, Dala'een R, Alharbi FA

Received 31 December 2019

Accepted for publication 31 March 2020

Published 15 April 2020 Volume 2020:14 Pages 737—746


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Fatimah AlHussain,1 Yazed AlRuthia,2,3 Hazem Al-Mandeel,4 Arwa Bellahwal,2 Fadia Alharbi,2 Yasser Almogbel,5 Oriana Awwad,6 Roua Dala’een,6 Fawaz Abdullah Alharbi7

1Department of Pharmacoeconomics and Drug Pricing, Saudi Food and Drug Authority, Riyadh, Saudi Arabia; 2Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4Department of Obstetrics and Gynecology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 5Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia; 6Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, University of Jordan, Amman, Jordan; 7Drug Information and Poison Centre, Al Ansaar General Hospital, Medina, Saudi Arabia

Correspondence: Yazed AlRuthia
Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
Tel +996 114677483
Fax +966 114677480

Background: Metformin is commonly prescribed to manage polycystic ovary syndrome (PCOS), which is one of the most common endocrine disorders among women of childbearing age and is associated with high prevalence rates of depression and anxiety.
Objective: This study’s objective was to determine the impact of prescribed metformin on depression and anxiety levels of patients with PCOS.
Methods: This prospective, multi-center, cohort study examined the impact of prescribed metformin on the depression and anxiety of women with PCOS in four gynecology clinics in Saudi Arabia and Jordan. The women had recently been prescribed metformin along with lifestyle modifications, such as diet and exercise, and were compared to another group of women with PCOS who were prescribed lifestyle modifications only. Depression and anxiety were assessed at baseline and three months later using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scale, respectively. Health-related quality of life was measured using the Short Form Health Survey (SF-36). Multiple logistic regression analyses were conducted to examine the impact of metformin on depression and anxiety.
Results: Eighty-six women participated in the study: 53 were prescribed metformin with lifestyle modifications, and 33 were prescribed lifestyle modifications only. The women on metformin had 70% lower odds of having major depression (PHQ-9≥ 10) (OR=0.302, P=0.045); however, no significant effect of metformin on anxiety (GAD-7≥ 10) was found.
Conclusion: Metformin may have a role in the management of depression symptoms among patients with PCOS; however, its potential antidepressant effect should be further examined in randomized double-blind placebo-controlled clinical trials.

Keywords: metformin, polycystic ovary syndrome, antidepressant activity

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