title: Menstrual exacerbation of schizophrenia symptoms.
abstract: OBJECTIVE
  To better understand premenstrual exacerbations of schizophrenia in women and weigh treatment options.
  
  
  METHODS
  A PubMed literature search was conducted, using the search terms 'schizophrenia', 'psychosis', 'menstrual exacerbation', 'hormones' and assessing relevance to premenstrual exacerbation of schizophrenia symptoms.
  
  
  RESULTS
  Exacerbations are usually distinguishable from periodic or menstrual psychosis, a relatively rare condition. Controversy continues about whether low estrogen periods of the month lead to an increase in schizophrenia symptoms among women of reproductive age or whether some women suffer from both schizophrenia and premenstrual dysphoric disorder (PMDD). No treatment trials of specific interventions have been conducted so that physicians must decide on a case-by-case basis whether to raise antipsychotic doses premenstrually, try estrogens or estrogen/progesterone combinations or selective estrogen receptor modulators, or target PMDD symptoms.
  
  
  CONCLUSIONS
  Clinicians need to be aware of premenstrual symptom aggravation in a large minority of women with schizophrenia. Treatment strategies will depend on the nature of the symptoms that are exacerbated. Optimal treatment needs to be adjusted to the individual woman.
authors.affiliation: Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, ON, Canada. mary.seeman@utoronto.ca
authors.forename: M V
authors.initials: MV
authors.lastname: Seeman
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D004347:Drug Interactions; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000523:psychology*; D011293:Premenstrual Syndrome / Q000150:complications* / Q000188:drug therapy; D011374:Progesterone / Q000627:therapeutic use; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D004967:Estrogens; D020845:Selective Estrogen Receptor Modulators; D011374:Progesterone