New Treatment for Women with Schizohprenia: Estrogen?
There's some interesting new research about the possible benefits of adding estrogen to the treatment of women with schizophrenia. In a study published in this month's Archives of General Psychiatry, women with schizophrenia who were given a transdermal patch of estrogen with antipsychotic medication had less symptoms, including psychotic symptoms and symptoms that contribute to general psychopathology.
The results come from a 28 day, double-blind, placebo-controlled study conducted at The Alfred and Monash University and The Alfred Hospital in Melbourne, Australia. 102 women with schizophrenia who were of childbearing age completed the study. 56 were given the transdermal patch of 100 micrograms of estradiol, the other 46 were given a placebo patch. By the end of the study the participants in the estradiol group had substantially less psychotic symptoms than those in the placebo group. Additionally, the women using the estradiol patches had greater reductions in general psychopathological symptoms than women using a placebo. The findings support the notion that estradiol may be useful as an additional treatment for women with schizophrenia.
This report by Dr. Kulkarni and colleagues supports other research that's been published over the last 20 years that suggested that estrogen treatment may have a positive influence in women with schizophrenia and other mental illness. For example, it's been noted that relapse rates and psychosis tends to improve during pregnancy, when estrogen levels are particularly high. The findings of this study are also in line with other research that has suggested that symptoms due to severe mental illness tend to improve in women during the high estrogen phases of the menstrual cycle, and worsen during the low estrogen phases.
There was no significant difference between side effects experienced by participants in the placebo or estrogen groups, so it seems that estrogen treatment was as well tolerated as the placebo patch. It's important to note that the study is not saying estrogen therapy alone is enough to chronically treat schizophrenia; in fact about a third of the participants were taking clozapine, considered one of the most powerful antipsychotic medications available in most countries. The participants in this study had very severe schizophrenia, so it's unclear what effect estrogen supplementation would have with people with less severe schizophrenia. I think it's also important to mention that a small group of women in the study who received estrogen supplementation had a profound improvement in psychotic symptoms, so in these cases the difference estrogen made was fairly important.
Hopefully these results will be repeated in an equally large or larger study. I have to stress that we as a community not jump to conclusions whenever a new, exciting research finding comes out, but these are promising results, and have already generated a lot of interest in the medical community. I'm interested in hearing your comments and any questions you may have.