Antipsychotic medications are commonly used to treat schizophrenia,but they can have negative effects on lipid metabolism,leading to an increased risk of cardiovascular diseases,reduced life expectancy,and difficulties with treatment adherence.The specific mechanisms by which antipsychotics disrupt lipid metabolism are not well understood.Sterol regulatory element-binding proteins(SREBPs)are important transcriptional factors that regulate lipid metabolism.Proprotein convertase subtilisin/kexin type 9(PCSK9),a gene regulated by SREBPs,plays a critical role in controlling levels of low-density lipoprotein cholesterol(LDL-C)and has become a focus of research on lipid-lowering drugs.Recent studies have shown that antipsychotic drugs can affect lipid metabolism through the SREBP/PCSK9 pathway.A deep understanding of the mechanism for this pathway in antipsychotic drug-related metabolic abnormalities will promote the prevention of lipid metabolism disorders in patients with schizophrenia and the development and application of new drugs.

Schizophrenia is a common chronic mental disorder.Cognitive dysfunction is one of its core symptoms,which severely affects the social functioning of patients.Currently,antipsychotic medication treatments have poor efficacy in improving cognitive functions.Recent studies have found that metformin can improve cognitive dysfunction in patients with schizophrenia.However,the mechanism of action remains unclear.This review summarizes the therapeutic effects of metformin on cognitive dysfunction in schizophrenia patients such as improving insulin resistance,repairing neuronal damage,regulating neuroimmunity,and combating oxidative stress,thereby providing new insights for the treatment of cognitive dysfunction in schizophrenia.