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Estrogen
relieves Psychotic Symptoms in Women with
Schizophrenia
Newswise — When combined with
antipsychotic medications, the estrogen
estradiol appears to be a useful treatment
in women with schizophrenia, according to a
report in the August issue of Archives of
General Psychiatry, one of the JAMA/Archives
journals.
The link between estrogen and
mental illness was recognized more than a
century ago, according to background
information in the article. However,
scientific evidence regarding estrogen as a
therapy for mental illness has only recently
emerged.
“Epidemiologic observations
of sex differences in the onset and course
of schizophrenia prompted exploration of
estrogen’s role in schizophrenia,” the
authors write.
Jayashri Kulkarni, M.B.B.S., M.P.M.,
F.R.A.N.Z.C.P., Ph.D., of The Alfred and
Monash University and The Alfred Hospital,
Melbourne, Australia, and colleagues
conducted a randomized, double-blind study
involving 102 women of child-bearing age
with schizophrenia.
For 28 days, 56 women were
randomly assigned to receive 100 micrograms
of estradiol daily via a skin patch and 46
women received a placebo skin patch in
addition to their regular medications.
Psychotic symptoms, which
include delusions and hallucinatory
behavior, were assessed weekly with a
commonly used scale.
The group of women taking estradiol
exhibited a greater improvement in psychotic
symptoms over time than did the women taking
antipsychotic medications alone.
They also experienced a
decline in positive symptoms—those which
represent a distortion of normal functions.
No difference was observed
between the two groups regarding negative
symptoms, those which occur when normal
functions are lost or diminished.
“Estrogen’s neuroprotective and
psychoprotective actions may be mediated by
a variety of routes, ranging from rapid
actions, including antioxidant effects and
enhancement of cerebral blood flow and
cerebral glucose utilization, to slower,
genomic mechanisms, which may include
permanent modification of neural circuits,”
the authors write.
“The lack of effect for
negative symptoms is consistent with
literature reporting that negative symptoms
are less responsive to treatment than other
symptoms of schizophrenia.
"It
is possible that longer-term treatment is
required for negative symptoms to respond to
treatment. Alternatively, brain regions
implicated in negative symptoms may be less
responsive to gonadal hormone effects.”
Estrogen may have a preventive role in women
with schizophrenia who undergo hormonal
changes shown to cause a deterioration of
their condition, such as those following
childbirth and menopause, the authors note.
“Estrogen treatment is
a promising new area for future treatment of
schizophrenia and potentially for other
severe mental illnesses,” they conclude.
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