Estrogens and men with schizophrenia: is there a case for adjunctive therapy?
Adjunctive use of estrogen therapy has been shown to be effective in enhancing the treatment of schizophrenia in women. In men, consideration of estrogen therapy has been impacted by concerns of feminising side effects, however, clinical trials of the use of estrogen in treating prostate cancer, bone density loss and even aggression and psychosis in dementia or traumatic brain injury, show this to be a safe and effective therapy. The current 14-day randomised placebo-controlled trial in 53 men with schizophrenia was conducted to evaluate the efficacy of 2 mg oral estradiol valerate as an adjunct to atypical antipsychotic treatment. Results demonstrated for estradiol participants a more rapid reduction in general psychopathology that occurred in the context of greater increases in serum estrogen levels and reductions in FSH and testosterone levels. Approximately 28% of estradiol participants did not achieve an increase (at least a 50% from baseline) in serum estrogen suggesting that further research is needed to refine the type, dose and administration route for estrogen therapy in men. Findings do, however, suggest further exploration of a therapeutic role for adjunctive estradiol treatment in men with schizophrenia is warranted.
Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, School of Psychology and Psychiatry, Level One, Old Baker Building, Commercial Road, Melbourne 3004, Australia. Jayashri.Kulkarni@med.monash.edu.au
Jayashri
J
Kulkarni
Anthony
A
de Castella
Barbara
B
Headey
Natasha
N
Marston
Kelly
K
Sinclair
Stuart
S
Lee
Caroline
C
Gurvich
Paul B
PB
Fitzgerald
Henry
H
Burger
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003687:Dehydroepiandrosterone / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy*; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D013739:Testosterone / Q000097:blood
D014150:Antipsychotic Agents; D013739:Testosterone; D003687:Dehydroepiandrosterone; D004958:Estradiol; D011388:Prolactin; D005640:Follicle Stimulating Hormone