metformin + olanzapine

Metformin + olanzapine is a combination of two small molecule drugs, metformin and olanzapine, used together primarily to manage the metabolic side effects associated with antipsychotic treatment. Metformin is an oral antihyperglycemic agent that works by decreasing hepatic glucose production, reducing intestinal absorption of glucose, and increasing insulin sensitivity through activation of AMP-activated protein kinase (AMPK). Olanzapine is an atypical antipsychotic that acts as an antagonist at multiple neurotransmitter receptors in the brain, including dopamine D2 and serotonin 5-HT2A receptors. While olanzapine is effective for treating schizophrenia and bipolar disorder, it commonly causes weight gain and insulin resistance. The addition of metformin has been shown in clinical studies to attenuate or prevent olanzapine-induced weight gain and metabolic disturbances in patients with schizophrenia[2][6][9]. This combination does not have a unique brand name or fixed-dose formulation but represents a therapeutic strategy supported by clinical guidelines for managing antipsychotic-induced weight gain[7].