Role of Estrogen Treatment in the Management of Schizophrenia

Abstract

Increasing evidence from epidemiological, preclinical and clinical studies suggests that estrogens may exert psychoprotective effects in schizophrenia. Observations of gender differences in the onset and course of schizophrenia have prompted exploration of the effects of estrogen on the CNS. The aim of this paper is to provide an overview of different applications of adjunctive estrogen as a possible treatment for symptoms of schizophrenia in both men and women. Recent trials have suggested that estrogen augmentation therapy may be able to enhance the management of schizophrenia; however, the clinical application of estrogen as a treatment has been limited by potential side effects, the most worrying being breast and uterine cancer in women, and feminization in men. Selective estrogen receptor modulators (SERMs), however, may offer therapeutic benefits for both men and women with schizophrenia without posing threat to breast and uterine tissue and without feminizing effects. The use of estrogen opens up new possibilities for both men and women in the treatment of severe mental illnesses such as schizophrenia. With further preclinical and clinical research, it is hoped that this promising field of hormone modulation can continue to evolve and eventually be translated into real therapeutic potential.

Associations between DNA methylation and schizophrenia-related intermediate phenotypes — A gene set enrichment analysis

“…Furthermore, sex differences have been described for nearly all features of schizophrenia [114]. Clinical studies suggest that estrogens exert psychoprotective effects in schizophrenia patients [115] which may be mediated by an interaction effect between estrogen and brain-derived neurotrophic factor (BDNF) [114]. …”

Maternal lipopolysaccharide treatment differentially affects 5-HT2A and mGlu2/3 receptor function in the adult male and female rat offspring

“…For example, men have an earlier age of disease onset, more deficit symptoms and a poorer response to antipsychotic drug treatment (Lindamer et al, 1997). Additionally, sex differences also exist regarding structural and functional brain abnormalities that may underlie the disease pathology (Cascio et al, 2012;Kulkarni et al, 2012;Gonzalez-Rodriguez et al, 2014). However, In the present study, we aimed at further characterizing the effects of prenatal LPS exposure on 5-HT 2A and mGlu2/3 receptor function in the adult rat offspring.…”

Early Antipsychotic Response Predictors in Schizophrenia: A Naturalistic Study

“…Previous research on this issue reported conflicting results, with some studies reporting a better outcome in men [23] and other in women [32]. In this case, some Authors suggested a possible protective role for estrogens through a direct anti-dopaminergic effect, although data are still lacking to draw definitive conclusions about this hypothesis [33].…”