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Estrogen for schizophrenia
W L Chua1, Santiago A de Izquierdo, J Kulkarni
1Bradford District Care Trust, City Mental Health Team, Horton Park Centre, 99 Horton Park Avenue, Bradford, West Yorkshire, UK BD7 3 EG. lian.chua@btinternet.com
The Cochrane Database of Systematic Reviews
|October 20, 2005
Summary
Estrogen therapy, alone or with progesterone, did not show significant benefits for schizophrenia treatment in women. Further research requires access to all completed and unpublished studies to justify new trials.
Area of Science:
- Psychiatry
- Neuroscience
- Endocrinology
Background:
- Women with schizophrenia exhibit different clinical outcomes than men, with increased vulnerability post-partum and post-menopause.
- Estrogen withdrawal is linked to these vulnerable periods, suggesting estrogen as a potential schizophrenia treatment.
- Hormone replacement therapy is being investigated for its effects on psychotic disorders.
Purpose of the Study:
- To assess the clinical efficacy of estrogens, with or without progesterone, as a standalone or adjunctive therapy for schizophrenia.
- To evaluate the impact of hormone therapy on psychotic symptoms and cognitive function in women with schizophrenia.
Main Methods:
- Systematic review of randomized clinical trials comparing estrogens (with or without progesterone) to placebo.
- Searches included the Cochrane Schizophrenia Group's Register and manual reference inspection.
- Data were analyzed independently using intention-to-treat principles, calculating relative risks and weighted mean differences.
Main Results:
- Evidence pertains to women only; four studies (n=108) compared estrogen to placebo, showing no significant differences in general mental state or study attrition.
- One study (n=14) comparing estrogen and progesterone to placebo found no difference in total scores but favored the hormone group for negative symptoms and visual retention test performance.
- No clear differences were observed in movement disorders, and study dropout rates were similar across groups.
Conclusions:
- Adjunctive estrogen therapy, with or without progesterone, does not provide clear advantages over placebo for schizophrenia treatment.
- Availability of all completed and unpublished research is crucial before initiating further trials to determine the justification for new studies.
- Further investigation into hormone therapy for schizophrenia requires a comprehensive understanding of existing evidence.