A treatment study by Fenton and Chavez (p. 1697) discusses the care of patients who develop the metabolic syndrome while taking second-generation antipsychotic drugs. Obesity, hypertension, and abnormal lipid, triglyceride, and glucose levels can be managed through both lifestyle and medication. The psychiatrist’s role thus expands to include monitoring of weight and pertinent laboratory test results. The physiology behind the metabolic effects of second-generation antipsychotics is not clear, and risk varies among drugs. Olfson et al. (p. 1821) found that hyperlipidemia among California Medicaid recipients was most strongly associated with clozapine, followed by risperidone, quetiapine, olanzapine, ziprasidone, and first-generation antipsychotics. Aripiprazole did not increase risk.