This study is important both from conceptual and clinical perspectives. The complicated effects of antipsychotic-induced weight gain include amenorrhea. It is postulated that these effects resemble polycystic ovary syndrome (PCOS). Metformin is known to alter dopaminergic activity in PCOS, and the results of this study reflect robust reversal of amenorrhea as well as reduction in weight gain. The findings of this study are compelling. These need to be replicated in other populations beyond this first-episode Chinese schizophrenia sample. It also raises the question as to whether drugs like metformin might be appropriate to give "prophylactically" with antipsychotics at the onset of treatment for some or all patients.

View all comments by Peter F. Buckley