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The effects on fetal development have not been studied, and the risk is not worth taking

In one meta-analysis of RCTs, metformin worked about three times as well when starting a new antipsychotic in first-episode psychosis (about a 13-pound difference from placebo) compared with its use after chronic antipsychotic treatment (about a 4-pound difference from placebo) (De Silva VA et al, BMC Psychiatry 2016;16(1):341)

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Drug manufacturers have built a supply chain for patients that routes around the trillion dollar PBM / insurer market