[Sex differences relating to psychiatric treatment]

This paper reviews the literature discussing the influence of gender factors on the efficacy of the most frequently used psychiatric treatments. It recommends taking into account patient gender in order to optimize the treatment efficacy and tolerance.

Pharmaceutical and psychotherapeutic treatments as well as other types of therapy (psychosurgery, electroconvulsive therapy [ECT]) are discussed in the overview. Each section draws intermediate conclusions.

Literature on the subject is scarce and uneven. From a pharmaceutical perspective, gender differences are marked; they affect substance absorption, distribution, metabolism, and elimination. As a result, differences in bioavailability affect efficacy and side effects of antidepressants, neuroleptics, and lithium as well as of hypnotics, sedatives, and anxiolytics. The menstrual cycle and birth-control pills also produce significant interactions. Few studies have discussed the influence of the gender-specific effect on the outcome of psychotherapy. However, some differences might exist, and serious further research is required before repeatable conclusions can be reached. Patient gender does not seem to affect certain physical kinds of treatment such as psychosurgery or ETC as much.

Patient gender has a definite influence on the efficacy of the treatment administered. This influence, however, is often limited and should be considered for the optimization of treatment response and tolerance. Research in this field of psychiatry should be encouraged.