Gender differences in antipsychotic prescribing.
OBJECTIVE
Optimum outcome for those with psychosis will necessarily involve treatment with antipsychotic medication. Unfortunately this medication is associated with a high rate of adverse effects and as a consequence non-adherence. Maximizing symptomatic relief whilst minimizing side effects is the aim of treatment. In order to do this adequately prescribers need to be aware of the significant differences between men and women in response to antipsychotic treatment. These differences are not simply biologically mediated; both physiological and sociocultural factors contribute.


METHODS
Findings from a variety of sources were used to summarize gender differences in antipsychotic treatment.


RESULTS
Pharmacokinetic and pharmacodynamic factors, the impact of reproductive phases in women and gender differences in antipsychotic prescription across the lifespan (from children and adolescents to the elderly) are discussed. Important ethnic and racial differences are also mentioned.


CONCLUSIONS
Women require less antipsychotic medication than men to achieve a better symptom response, but this is at the expense of a higher side effect burden, in particular hormonal and metabolic side effects. Children, adolescents and the elderly are at especially high risk of adverse reactions with antipsychotics. In order to optimize outcome in people with psychosis, prescribers should ensure that gender differences are taken into account.
Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry at Kings College London, De Crespigny Park, London, UK. shubulade.smith@kcl.ac.uk
Shubulade
S
Smith
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000187:drug effects* / Q000523:psychology; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects* / Q000493:pharmacokinetics; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy*; D012098:Reproduction / Q000187:drug effects*; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014930:Women / Q000523:psychology*
D014150:Antipsychotic Agents