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Estrogen for Schizophrenia

Posted Oct 03 2008 11:31am
Seems like estrogen has more and more roles as time goes by.

Now, we can use it for the treatment of schizophrenia. An Australian study in the Archives of General Psychiatric showed schizophrenic women who get an estrogen patch along with their regular antipsychotic medications have fewer symptoms than women who get inactive placebo patches.

It's a randomized, double-blind study, involving 102 women of childbearing age with schizophrenia. All participants were in an acute or chronic phase of their illness.

Patients were randomized to receive 100 µg of transdermal estradiol {the most important form of estrogen in the body} (n = 56) or transdermal placebo (n = 46) for 28 days.

Psychopathological symptoms were assessed weekly on their positive and negative symptoms. (Schizophrenia is often described in terms of positive and negative symptoms.)

Positive symptoms (Psychosis):
Delusions, auditory hallucinations, and thought disorder

Negative symptoms (Depression):
Poverty of speech, inability to experience pleasure, and lack of motivation

The results?

The addition of 100 µg of transdermal estradiol significantly reduced positive and general psychopathological symptoms during the 28-day trial period compared with women receiving antipsychotic medication alone.

However, the estrogen did not help in improving negative symptoms. In fact, negative symptoms are naturally less responsive to therapy and require longer-term care.

Actually, the link between estrogen and mental illness was recognised through observation for quite some time already:
  • The female sex hormone estrogen has important effects on chemical signals in the brain, and these signals go haywire in schizophrenia.
  • Women's first episodes of schizophrenia occur later in life than men's, suggesting a protective role for estrogen.
  • In women, schizophrenia symptoms often appear just after childbirth and during menopause, when estrogen levels drop.
  • Women with schizophrenia often relapse during the low-estrogen phase of their menstrual cycles.
Estrogen, besides its actions as a sex hormone, it plays many roles in the brain. As estrogen found abundantly in women, it's not wrong for us for say women are complicated (HeHe).

So, with the result obtained from the study, and the observations throughout the years, some experts said if given over short periods, estrogen therapy may be useful in women with schizophrenia after childbirth or menopause, when women with the disease are more prone to relapse. It may also be useful during low-estrogen phases of a woman's menstrual cycle.

However, we have to bear in mind that this is a small study and it needs to be followed up with further research (more larger-scale, longer term studies) before we can recommend the use of estrogen in schizophrenic women patients.

  1. Jayashri Kulkarni et al. Estrogen in Severe Mental Illness: A Potential New Treatment Approach. Arch Gen Psychiatry 2008; 65: 955-960
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