Estrogen - a potential treatment for schizophrenia

Estrogen has been shown in animal studies to modulate both the dopamine and serotonin neurotransmitter systems - the main neurotransmitters implicated in the pathogenesis of schizophrenia, A double blind, 28 day, placebo-controlled study was conducted with three groups of women of child-bearing age (N= 12 in each group) who received standardized antipsychotic medication plus 50 mcg transdermal estradiol or 100 mcg transdermal estradiol or transdermal placebo. Analyses show that women receiving 100 mcg of estradiol made greater improvements in the symptoms of schizophrenia than both the 50 meg estradiol and placebo groups. Women receiving 50 mcg estradiol had more improvement in their symptoms compared with the placebo group. The 100 mcg estradiol group had significantly lower mean lutenizing hormone (LH) and higher mean prolactin levels across the study period compared with both the 50 mcg and placebo groups. The addition of 100 mcg adjunctive transdermal estrogen significantly enhanced the treatment of acute, severe psychotic symptoms in women with schizophrenia. The differential response of adding 50 mcg versus 100 mcg estradiol on the types of symptom affected may be related to the estrogen effect on LH and prolactin, The positive impact of estrogen treatment on psychotic symptoms by a direct effect on dopamine and serotonin systems or via an indirect prolactin-mediated effect may be very useful in the overall treatment of women with schizophrenia. (C) 2001 Elsevier Science B,V. All rights reserved.