title: Raloxifene adjunctive therapy for postmenopausal women suffering from chronic schizophrenia: a randomized double-blind and placebo controlled trial.
abstract: BACKGROUND
  Cumulative evidence from epidemiological, preclinical and clinical studies suggests estrogens may have psychoprotective effects in schizophrenic patients. Selective Estrogen Receptor Modulators could have therapeutic benefits in schizophrenia for both sexes without being hazardous to gynecological tissues or having feminizing effects. Few studies have been conducted regarding the effects of raloxifene on postmenopausal women suffering from schizophrenia. We conducted this placebo-controlled trial to compare the add-on effect of raloxifene to risperidone versus risperidone with placebo.
  
  
  METHODS
  This was an 8-week, parallel-group, placebo-controlled trial undertaken at two universities affiliated psychiatric Hospitals in Iran. Forty-six postmenopausal women with the definite diagnosis of schizophrenia were enrolled in the study. Patients received risperidone (6 mg/day in 3 divided doses) combined with either placebo (N = 23) or 120 mg/day of raloxifene (N = 23) for 8 weeks. Patients were assessed by a psychiatrist at baseline and at 2 and 8 weeks after the start of medical therapy. Efficacy was defined as the change from baseline to endpoint in score on Positive and Negative Syndrome Scale (PANSS).
  
  
  RESULTS
  For PANSS scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 1.77, p = 0.18]. For positive subscale scores, there was marginal significant interaction between intervention type and time [F (2, 47) = 2.93, p = 0.06] and there was substantial main effect for time [F (2, 47) = 24.39, p = 0.001] within both groups showing reduction in positive subscale scores across the three time periods. In addition, the main effect comparing two types of intervention was significant [F (1, 48) = 3.78, p = 0.02]. On the other hand, for negative subscale scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 1.43, p = 0.23]. For general subscale scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 0.03, p = 0.86].
  
  
  CONCLUSIONS
  According to our findings, raloxifene as an adjunctive treatment to risperidone was only superior in improvement of positive symptoms and it was not effective in treating negative and general psychopathology symptoms.
  
  
  BACKGROUND
  The trial was registered at the Iranian registry of clinical trials: IRCT201205131556N42.
authors.forename: Gilda
authors.initials: G
authors.lastname: Kianimehr
authors.forename: Farzad
authors.initials: F
authors.lastname: Fatehi
authors.forename: Sara
authors.initials: S
authors.lastname: Hashempoor
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Khodaei-Ardakani
authors.forename: Farzin
authors.initials: F
authors.lastname: Rezaei
authors.forename: Ali
authors.initials: A
authors.lastname: Nazari
authors.forename: Ladan
authors.initials: L
authors.lastname: Kashani
authors.affiliation: Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, South Kargar Street 13337, Tehran, Iran. S.akhond@neda.net.
authors.forename: Shahin
authors.initials: S
authors.lastname: Akhondzadeh
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011569:Psychiatric Status Rating Scales; D020849:Raloxifene Hydrochloride / Q000008:administration & dosage*; D018967:Risperidone / Q000008:administration & dosage; D012559:Schizophrenia / Q000188:drug therapy*; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride; D018967:Risperidone