Evaluation of prolactin levels in male patients with first-episode schizophrenia and its correlation with psychopathology

Taweel, Mohamed El Sayed El; Abdalla, Ahmed M.

doi:10.1097/01.xme.0000513069.03258.07

Cited by 5 publications

(3 citation statements)

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“…Within this framework, primary estrogen deficiency results from stress-induced increased prolactin secretion. This hypothesis is in line with recent studies showing that higher prolactin levels are associated with more severe psychotic [76 ▪▪ ] and negative [73] symptoms in these treatment naïve patients. Other studies showed, conversely, that prolactin levels are inversely associated with treatment response [77–79].…”

Section: Introductionsupporting

confidence: 91%

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Estrogens in schizophrenia: progress, current challenges and opportunities

Brand

Boer

Sommer

2021

Current Opinion in Psychiatry

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Purpose of review Schizophrenia is a heterogeneous psychiatric disorder with a different, but not necessarily milder clinical presentation in women as compared to men. These sex differences have largely been attributed to the protective role of estrogens. This article reviews the current state of estrogen research in schizophrenia. Recent findings Estrogens regulate important pathophysiological pathways in schizophrenia, including dopamine activity, mitochondrial function, and the stress system. Estrogen deficiency is common in both sexes and is associated with increases in psychotic symptoms. Hyperprolactinemia causes secondary estrogen deficiency and can be a reaction to stress, or secondary to prolactin-raising antipsychotics. Therefore, prolactin-sparing antipsychotics should be preferred especially in premenopausal women, who are more prone to hyperprolactinemia. Premenopausal women furthermore require lower doses of antipsychotics than men, since estrogens raise the availability and efficacy of antipsychotics. Summary The past years have established the importance of estrogens in the pathophysiology of schizophrenia and have shown its relevance to clinical practice through its influence on antipsychotic drug efficacy. Future research should focus on the neurobiological and clinical effect of contraceptives in premenopausal women with schizophrenia. Furthermore, the potential of estrogen-like augmentation with raloxifene and phytoestrogens in schizophrenia should be established in the coming years.

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Section: Introductionsupporting

confidence: 91%

“…2) [69 ▪ ]. However, hyperprolactinemia is also observed in antipsychotic-naïve patients of both sexes with (prodromal) psychosis [70–75,76 ▪▪ ]. It is hypothesized that this primary hyperprolactinemia is a result of the stress response system, since stress can induce the secretion of prolactin [9].…”

Section: Introductionmentioning

confidence: 99%

Estrogens in schizophrenia: progress, current challenges and opportunities

Brand

Boer

Sommer

2021

Current Opinion in Psychiatry

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“…Studies have shown that patients with high prolactin levels are less responsive to treatment (19). Higher prolactin levels are associated with more severe positive (20) and negative (21) psychotic symptoms in patients with uncontrolled symptoms. This finding is consistent with the patient's performance in this case.…”

Section: Discussionmentioning

confidence: 99%

Paliperidone long-acting injection in the treatment of an adolescent with schizophrenia with fluctuating mental symptoms during menstrual period: a case report

Wang,

Chen,

Guo

et al. 2023

Front. Psychiatry

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BackgroundThe treatment of schizophrenia, a chronic disabling psychiatric disorder, mainly relies on antipsychotics to control the disease and improve clinical symptoms. Various medication options are available, and differences in treatment effects, even for the same medication, have been noted. Treatment efficacy is correlated with the patient’s sex, age, and physical condition. When a drug fails to achieve the desired effect or the symptoms are unstable, the drug dose is often increased or a change in medication is advised according to the patient’s situation.Case presentationWe report the case of a 16 years-old girl with schizophrenia and apparent psychotic symptoms. According to the genetic testing results, the symptoms were effectively controlled, and she was discharged from the hospital with the prescription of paliperidone sustained-release tablets. During the follow-up, her symptoms fluctuated during menstrual period, causing her great distress. Furthermore, her compliance gradually declined during the following 2 years of treatment, and the medication was often discontinued. We changed the drug from an oral tablet to an injection preparation while maintaining the active ingredients of the drug. The patient’s symptoms were significantly controlled, and no fluctuation of symptoms occurred during the menstrual cycle.ConclusionLong-acting antipsychotic injections can be administered to female adolescents with schizophrenia who experience fluctuating psychotic symptoms during menstruation. This technique can ensure both consistency of medication and improvement in clinical symptoms.

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Estrogen and psychosis — a review and future directions

Mu,

Gurvich,

Kulkarni

2024

Arch Womens Ment Health

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The link between sex hormones and schizophrenia has been suspected for over a century; however, scientific evidence supporting the pharmacotherapeutic effects of exogenous estrogen has only started to emerge during the past three decades. Accumulating evidence from epidemiological and basic research suggests that estrogen has a protective effect in women vulnerable to schizophrenia. Such evidence has led multiple researchers to investigate the role of estrogen in schizophrenia and its use in treatment. This narrative review provides an overview of the effects of estrogen as well as summarizes the recent work regarding estrogen as a treatment for schizophrenia, particularly the use of new-generation selective estrogen receptor modulators.

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Evaluation of prolactin levels in male patients with first-episode schizophrenia and its correlation with psychopathology

Cited by 5 publications

References 50 publications

Estrogens in schizophrenia: progress, current challenges and opportunities

Estrogens in schizophrenia: progress, current challenges and opportunities

Paliperidone long-acting injection in the treatment of an adolescent with schizophrenia with fluctuating mental symptoms during menstrual period: a case report

Estrogen and psychosis — a review and future directions

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