GENDER, ESTROGEN, AND SCHIZOPHRENIA

Most of the evidence to support an association between estrogen and ps ychosis is indirect and comes from clinical studies of gender differen ces in schizophrenia and from studies of fluctuating levels of psychop athology in different phases of the menstrual cycle. Our data, as well as those of other investigators, suggest a significantly later age at onset of schizophrenia in women than in men. There is somewhat more d irect evidence from animal studies indicating that estrogen modulates dopamine systems in a manner similar to neuroleptics, although there a re some inconsistencies in the literature. Few studies have examined t he effects of estrogen administration in conjunction with neuroleptics on psychotic symptoms. We present a case report of a postmenopausal w oman with schizophrenia who had an improvement in positive symptoms wi th estrogen replacement therapy. Long-term double-blind treatment stud ies are needed to investigate the effects of estrogen on psychotic sym ptoms in women with schizophrenia.