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metformin + sertraline is a combination therapy investigated by the Washington University School of Medicine for the treatment of major depressive disorder, specifically in overweight or obese patients. This therapeutic strategy utilizes metformin, a biguanide insulin-sensitizing agent, to augment the effects of sertraline, a selective serotonin reuptake inhibitor (SSRI). The rationale behind this combination is that insulin resistance and metabolic dysfunction may impair the efficacy of standard antidepressants; by activating AMP-activated protein kinase (AMPK) and improving glucose metabolism, metformin is hypothesized to enhance the clinical response to sertraline. This approach targets the intersection of metabolic health and mental health, aiming to improve outcomes in treatment-resistant or sub-optimally responding depressed patients with high body mass index.
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