NEW ORLEANS—U.S. veterans have a high prevalence of post-traumatic stress disorder, but the search for effective medications continues.

A presentation at the American Diabetes Association’s 80th Scientific Sessions raised the possibility that a common diabetes drug might help. Tulane University School of Public Health and Tropical Medicine-led researches pointed out that nearly 25% of veterans have diabetes, for which metformin is a first-line treatment.1

“Although metformin is associated with improved neurodegenerative outcomes, there is no evidence on the association between metformin and PTSD-related symptom relief,” according to the authors, who said they sought to examine whether metformin was associated with a clinically meaningful reduction in PTSD symptoms— ≥20 points reduction PTSD checklist for DSM-5 {PCL-5}) score—among veterans with the condition, using VHA data.

Researchers defined the metformin cohort as first metformin use after a recorded PTSD diagnosis with a PCL-5 score ≥33 (i.e., clinical cut-score). The control cohort—i.e., never used metformin—was selected by propensity score 1:1 matching on the likelihood of initiating metformin with the covariates of age, gender, race, durations of PTSD, diabetes and depression and baseline CCI, PCL-5, and PHQ-9 scores.

Included in the review were 7,950 veterans with a mean age of 51.9; most were male, 85%, and white, 61.4%, with confirmed PTSD. Follow-up lasted a median of 1.2 years in both cohorts.

The baseline PCL-5 score was 56.2±11.6 and 56.5±11.7 in metformin and control cohort, respectively. Results indicated, however, that the metformin-treated cohort was more likely to have a clinically meaningful reduction in PTSD symptoms (adjusted hazard ratio (aHR): 1.31, 95%CI: 1.16-1.48), compared with the control cohort.

“Furthermore, patients on metformin ≥2 years were 22% more likely to reduce PTSD symptoms (aHR: 1.22, 95%CI: 1.04-1.43), compared with metformin exposure <2 years. Metformin exposure may be beneficial to PTSD symptoms among veterans,” the authors reported.

1. Liu S, Raines AM, Yoshida Y, Tang W, et. Al. Association between Metformin Treatment and Improved Symptoms of Post-Traumatic Stress Disorder. Presented at the American Diabetes Association’s 80th Scientific Sessions, Virtual. June 12-16, 2020.