Estrogen in severe mental illness: a potential new treatment approach.
BACKGROUND
Accumulating evidence suggests that estrogens may have therapeutic effects in severe mental illnesses, including schizophrenia, via neuromodulatory and neuroprotective activity.


OBJECTIVE
To compare the efficacy of adjunctive transdermal estradiol with that of adjunctive placebo in the treatment of acute psychotic symptoms.


METHODS
Randomized, double-blind study.


METHODS
Patients were recruited from inpatient acute hospital wards and outpatient clinics of 2 metropolitan Melbourne general hospitals.


METHODS
One hundred two women of childbearing age with schizophrenia. All participants were in an acute or chronic phase of their illness; 73 participants were outpatients and the rest were inpatients. Intervention Patients were randomized to receive 100 microg of transdermal estradiol (n = 56) or transdermal placebo (n = 46) for 28 days.


METHODS
Psychopathological symptoms were assessed weekly with the Positive and Negative Syndrome Scale.


RESULTS
The addition of 100 microg of transdermal estradiol significantly reduced positive (P < .05) and general psychopathological (P < .05) symptoms during the 28-day trial period compared with women receiving antipsychotic medication alone.


CONCLUSIONS
Estradiol appears to be a useful treatment for women with schizophrenia and may provide a new adjunctive therapeutic option for severe mental illness.


BACKGROUND
clinicaltrials.gov Identifier: NCT00206570.
Kulkarni
Jayashri
J
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry, and Psychological Medicine, The Alfred Hospital, Melbourne, Victoria 3004, Australia. j.kukarni@alfred.org.au
de Castella
Anthony
A
Fitzgerald
Paul B
PB
Gurvich
Caroline T
CT
Bailey
Michael
M
Bartholomeusz
Cali
C
Burger
Henry
H
D000208:Acute Disease; D000279:Administration, Cutaneous; D000328:Adult; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D012559:Schizophrenia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology
D004958:Estradiol