Researchers at the Monash Alfred Psychiatry Research Center pooled data from a randomized controlled trial of 120 mg/day oral raloxifene hydrochloride versus oral placebo to determine if this drug given to postmenopausal women to combat osteoporosis could improve symptoms in women who were postmenopausal and had schizophrenia. The medication, a selective oestrogen receptor modulator, acts as an oestrogen antagonist in breast tissue and it was hoped to have agonistic action in the brain with few oestrogenic side effects, according to the authors of the study published this year online in Psychoneuroendocrinology.
The research project leader and director of the Alfred professor Jayashri Kulkarni said those women in the trial given 120 mg a day of raloxifene had "significantly greater improvement in psychosis symptoms compared with those on placebos and lower doses." The women also experienced "enhanced memory and higher learning capacity."
The ones who had long-term disabling symptoms of schizophrenia benefited the most from these improvements in their mental health. More rapid recovery in positive PANSS symptoms was observed as well yet researchers said this result had to be confirmed in larger trials. 35 women were studied and given either 120 mg raloxifene, a placebo or 60 mg raloxifene.
Unlike estradiol, an estrogen in oral contraceptives or hormone replacement therapy, raloxifene did not have the same side effects on breast, uterus, and ovarian tissue. The authors wrote that an action of the study drug-inhibiting bone resorption-is also a benefit to postmenopausal women with schizophrenia: "Decreased bone mineral density is more common in individuals with psychiatric disorders such as schizophrenia and depression than in the general population and some antipsychotics and SSRIs directly reduce BMD."
The researchers admitted their findings were not definitive because of the small sample size and the use of pooled analysis. They will continue to investigate the efficacy of raloxifene.
I hope that a larger study will replicate the results and give us optimism not only for postmenopausal women with schizophrenia but for all older people with schizophrenia who might have gotten sick when relatively few good medication options existed. A person could be in their fifties or sixties or even older yet that is not a reason to ignore their pain. This is a quality of life issue. Everyone living with schizophrenia no matter how many years they have left to live deserve to add life to their years as opposed to years to their life as the expression goes.
As well, it is my contention that such drugs as raloxifene should be studied to observe whatever protective benefits they might have to brain tissue and whether they can reverse the loss of brain functioning that occurs when a person goes untreated longer than a year.
Also: we all secretly know that certain people diagnosed with schizophrenia have been unable to recover to the great degree that others currently are able to due to the fact they got sick before real help was available.
I would be a fan of this drug or any other treatment that levels the playing field.
You can access a list of psychiatric clinical trials like the one at the Alfred in Melbourne, Australia via the clinical trials web site.
Published On: April 20, 2010