Estrogen augmentation in schizophrenia: A quantitative review of current evidence

Sex differences in first-episode psychosis and in people at ultra-high risk

“…The finding may have implications also for research on the etiology of schizophrenia and in clinical practice, since disease characteristics that differ by sex point to gender specificity in altered neurobiology and may suggest new treatment approaches -for example, estrogen augmentation (Begemann et al, 2012).…”

Sex hormones and oxytocin augmentation strategies in schizophrenia: A quantitative review

“…Indeed, female patients with schizophrenia in the low estrogen phase of their menstrual cycle have more severe symptoms (Grigoriadis and Seeman, 2002), and studies controlling for estrogen plasma levels demonstrate a negative correlation between 17β-estradiol levels and severity of schizophrenia symptoms in women (Gattaz et al, 1994;Riecher-Rössler et al, 1994;Bergemann et al, 2007), as well as in men (Kaneda and Ohmori, 2005). In a previous review article, we performed a meta-analysis of five randomized controlled trials (RCTs) on the efficacy of estrogen augmentation in premenopausal women with schizophrenia and found a significant mean effect on total, positive, and negative symptom severity (Begemann et al, 2012). However, estrogens exert risk of endometrial hyperplasia if not combined with progestogens and cancer in women (Beral et al, 2002), and in male patients, feminizing effects.…”

Schizophrenia during Menopausal Transition

“…Clinical trials looking at estrogen therapy in chronic schizophrenia have primarily looked at younger women or women late in menopause [10]. Although these studies show improvement in psychotic symptoms, they use unopposed estrogen, which would limit potential therapy for women with an intact uterus or those who are still at risk for pregnancy.…”

“…Estrogen was found to decrease psychotic symptoms in younger premenopausal women with schizophrenia in a metaanalysis done by Begemann in 2011 [10] of 4 small randomized, controlled trials. The authors recommended future trials as their n of 214 was too small for clinical application.…”