We are thankful to the author for his comments on our article.(1) The author has rightly suggested that schizophrenia patients should stand up frequently, as this may result in better weight transmission to the lower part of the body and help in more optimal blood flow to the head and neck. In fact, we have plans to monitor this area in future research.

We also agree with the author concerning the benefits of exercise in schizophrenia patients, since exercising leads to better blood flow in the body, thus relieving oxidative stress. Interestingly, studies have found that schizophrenia patients tend to lack exercise,(2) show indifference toward exercising and have high levels of inactivity due to prolonged hospitalisation.(3) As oxygen and glucose demand increases following any form of physical activity, exercise may be beneficial at any stage of the disease. Therefore, we contend that the role of physiotherapists cannot be undermined in the management of schizophrenia patients.

Yours sincerely,
Ahmad Hatim Sulaiman, Mas Ayu Said, Srijit Das
Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.


1. Said MA, Sulaiman AH, Habil MH, et al. Metabolic syndrome and cardiovascular risk among patients with schizophrenia receiving antipsychotics in Malaysia. Singapore Med J 2012; 53:801-7.
2. Brown S, Birtwistle J, Roe L, Thompson C. The unhealthy lifestyle of people with schizophrenia. Psychol Med 1999; 29:697-701.
3. Aronne LJ. Epidemiology, morbidity, and treatment of overweight and obesity. J Clin Psychiatry 2001; 62 Suppl 23:13-22.