Estrogen in severe mental illness: A potential new treatment approach.

Abstract

Context: Accumulating evidence suggests that estrogens may have therapeutic effects in severe mental illnesses, including schizophrenia, via neuromodulatory and neuroprotective activity. Objective(s): To compare the efficacy of adjunctive transdermal estradiol with that of adjunctive placebo in the treatment of acute psychotic symptoms. Design(s): Randomized, double-blind study. Setting(s): Patients were recruited from inpatient acute hospital wards and outpatient clinics of 2 metropolitan Melbourne general hospitals. Participant(s): One hundred two women of childbearing age with schizophrenia. All participants were in an acute or chronic phase of their illness; 73 participants were outpatients and the rest were inpatients. Intervention(s): Patients were randomized to receive 100 mug of transdermal estradiol (n=56) or transdermal placebo (n=46) for 28 days. Main Outcome Measure(s): Psychopathological symptoms were assessed weekly with the Positive and Negative Syndrome Scale. Result(s): The addition of 100 mug of transdermal estradiol significantly reduced positive (P<.05) and general psychopathological (P<.05) symptoms during the 28-day trial period compared with women receiving antipsychotic medication alone. Conclusion(s): Estradiol appears to be a useful treatment for women with schizophrenia and may provide a new adjunctive therapeutic option for severe mental illness. Trial Registration: clinicaltrials.gov Identifier: NCT00206570. ©2008 American Medical Association. All rights reserved.