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It was a small trial 12 participants, no placebo group and the researchers themselves called the results preliminary

Treating insulin resistance with metformin as a strategy to improve clinical outcomes in treatment-resistant bipolar depression (the TRIO-BD Study): a randomized, quadruple-masked, placebo-controlled clinical trial

The first enzyme, glutamatecysteine ligase (GCL) formerly called -glutamylcysteine synthase (GCS) is the rate-limiting enzyme

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In addition, age dependent accretion of dysfunctional mitochondria elevates stress level, which is exhibited by high levels oxidized products such as protein carbonyls and lipid peroxides 42