Menstrually related symptom changes in women with schizophrenia

Harris, Andiea Hedayat

doi:10.1016/s0920-9964(97)00073-x

Cited by 22 publications

(13 citation statements)

References 11 publications

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“…It has to be noted that an elevated number of admissions during the perimenstrual period has also been identified in other disorders [37], and exacerbation of many psychiatric symptoms (not only psychotic ones) during the perimenstrual period was observed in patients with schizophrenia and related psychoses [27,38]. In theory, this lack of specificity is to be expected because of the multiple effects of estrogen on mental functioning.…”

Section: Clinical Findingsmentioning

confidence: 99%

Estrogens and Gonadal Function in Schizophrenia and Related Psychoses

Riecher-Rössler¹,

Kulkarni

2010

Biological Basis of Sex Differences in Psychopharmacology

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Section: Clinical Findingsmentioning

confidence: 99%

Estrogens and Gonadal Function in Schizophrenia and Related Psychoses

Riecher-Rössler¹,

Kulkarni

2010

Biological Basis of Sex Differences in Psychopharmacology

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“…These paradigms allow for assessment of symptoms in relation to significant change in hormone levels across specific menstrual phases as well as average hormone levels across different phases. Four (Hallonquist et al, 1993, Riecher-Rossler et al, 1994, Choi et al, 2001, Bergemann et al, 2007) of six (Harris, 1997, Thompson et al, 2000) studies in premenopausal women with schizophrenia demonstrate improved clinical symptoms in relation to natural fluctuations across the menstrual cycle; specifically, symptom improvement was evident in the midluteal (high estrogen/progesterone) versus the early follicular (low estrogen/progesterone) phase. In two of these studies, higher estradiol levels were associated with improved clinical symptoms and in particular positive symptoms (Riecher-Rossler et al, 1994, Bergemann et al, 2007).…”

Section: Introductionmentioning

confidence: 97%

“…In two of these studies, higher estradiol levels were associated with improved clinical symptoms and in particular positive symptoms (Riecher-Rossler et al, 1994, Bergemann et al, 2007). Of the two studies finding no cycle-related changes, one did not validate menstrual cycle phase with hormone assays (Harris, 1997) and the other did not tightly control menstrual cycle phase (Thompson et al, 2000), allowing for a wide range of estradiol and progesterone levels. Animal studies suggest that estrogen can upregulate the synthesis of oxytocin (Young et al, 1998, Patisaul et al, 2003), but the relationship between oxytocin and clinical symptoms has not been investigated in a menstrual cycle study, and no previous study has examined endogenous oxytocin levels over time in relation to clinical symptom severity.…”

Section: Introductionmentioning

confidence: 99%

Peripheral oxytocin is associated with reduced symptom severity in schizophrenia

Rubin

Carter

Drogos

et al. 2010

Schizophrenia Research

211

156

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Background-Emerging evidence from clinical trials suggests that oral estrogen and intranasal oxytocin might reduce symptom severity in schizophrenia. Whether increases in endogenous hormones are similarly associated with improved symptoms is unknown. We investigated the effects of menstrual cycle phase and related fluctuations in peripheral hormone levels on clinical symptoms in women with chronic schizophrenia.Method-Twenty-three women with schizophrenia were administered the Positive and Negative Syndrome Scale (PANSS), a measure of clinical symptom severity, at two menstrual cycle phases: 1) early follicular (Days 2-4; low estrogen/progesterone) and 2) midluteal (Days 20-22; high estrogen/progesterone). Twenty-seven males with schizophrenia and 58 controls (31 female) completed testing at comparable intervals. Men were included to examine whether the relationships between clinical symptoms and hormone levels in women generalize to men. Plasma hormone assays of estrogen, oxytocin, progesterone, and testosterone were obtained.Results-Female patients showed less severe symptoms during the midluteal versus early follicular phase (p's<0.01). Oxytocin did not fluctuate across phases, but in female patients (p's<0.01) higher oxytocin levels were associated with less severe positive symptoms and overall psychopathology. In both sexes, higher oxytocin levels were associated with more prosocial behaviors (p<0.05).Requests for reprints and correspondences should be addressed to: Leah H. Rubin, Ph.D., University of Illinois at Chicago, Department of Psychiatry, 912 S. Wood St. (MC 913), Chicago, Illinois 60612, (312) 355-5017 (phone), (312) 413-7856 (fax), lrubin@psych.uic.edu. Contributors Drs. Rubin and Maki conceived the idea and methodology for the study. Dr. Carter developed the methodology to explore oxytocin and served as an advisor and resource on this project for understanding oxytocin. Dr. Sweeney served as an advisor on this project and provided his expertise in schizophrenia. Dr. Pournajafi-Nazarloo and Ms. Drogos ran the oxytocin assays. Dr. Rubin, Dr. Maki's lab, and the Center for Cognitive Medicine were involved in recruitment and clinical assessments. Dr. Rubin conducted the statistical analyses and wrote the first draft. Drs. Rubin, Maki, Carter, and Sweeney exchanged multiple versions of the manuscript. All authors contributed to the writing of the manuscript and approval of the final version. Conflict of interestDr. Sweeney is a consultant to Pfizer and has a research grant from Janssen. Dr. Maki received honoraria from the American Nutraceutical Association and research support from the Soy Health Research Program. All other authors declare that, except for income received from their primary employer, no financial support or compensation has been received from any individual or corporate entity over the past 3 years for research or professional service, and there are no personal financial holdings that could be perceived as constituting a potential conflict of interest.Publisher's Disclaimer:...

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“…In the work by Riecher-Rossler and colleagues (18), higher estradiol levels were closely associated with less severe positive symptoms of psychosis. A 4th study also found symptom changes over the menstrual cycle in women with schizophrenia, but the changes were not particular to any one phase of the cycle; the symptoms affected were, in the main, mood symptoms (19). The author of this study concluded that, in some women, premenstrual symptoms are superimposed, or added to, psychotic symptoms rather than being symptoms of the original illness aggravated by hormones.…”

Section: Early Work On Menses and Symptom Severity In Schizophreniamentioning

confidence: 74%

Menstrual exacerbation of schizophrenia symptoms

Seeman

2012

Acta Psychiatr Scand

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Clinical recommendations• Clinicians treating women with schizophrenia need to inquire about menstrual exacerbation of symptoms.• The nature of the symptoms that are premenstrually exacerbated will determine the correct intervention.• Raising the dose of prolactin-raising antipsychotics can be counterproductive because estrogen levels can fall and ovulation can be inhibited. Additional comments• There are inherent safety risks to treatment with estrogens, but selective estrogen receptor modulators (SERMs) may prove to be effective.• SERMs, like oral estrogens, can affect CYP enzymes that metabolize individual antipsychotics.

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Menstrually related symptom changes in women with schizophrenia

Cited by 22 publications

References 11 publications

Estrogens and Gonadal Function in Schizophrenia and Related Psychoses

Estrogens and Gonadal Function in Schizophrenia and Related Psychoses

Peripheral oxytocin is associated with reduced symptom severity in schizophrenia

Menstrual exacerbation of schizophrenia symptoms

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