Sarah Kane's play 4-48 Psychosis
For over a century the link estrogen and mental illness has been known. Now estrogen may become therapy for mental illness.
For example, Women experiencing early onset menopause could develop dementia at a younger age. There is a correlation between women with Down Syndrome, who are known to have an early onset of menopause, and the age which dementia is diagnosed.
“We’ve known for some time that when the level of estrogen is low, vulnerability to psychotic symptoms increases and anti-psychotic drugs are less likely to work” said Prof. Weiner of Tel Aviv University.
As men seem less likely to begin schizophrenia after their 40s this suggested a link to estrogen.
Weiner and doctoral student Michal Arad found that restoring normal levels of estrogen may work as a protective agent in menopausal women vulnerable to schizophrenia. Their findings were published in Psychopharmacology.
They removed the ovaries of female rats, the resulting menopause-like low levels of estrogen led to schizophrenia-like behavior. The researchers then tried to eliminate this abnormal behavior with an estrogen replacement treatment or with the antipsychotic drug haloperidol.
Low amounts estrogen increases the effectiveness of anti-psychotic drugs.
Estrogen replacement therapy alleviated schizophrenia-like behavior but haloperidol had no effect on its own. However, Haloperidol regained its effect when supplemented by estrogen.
“When the level of estrogen was low, we could see psychotic-like behavior in the animals. Moreover, the sensitivity to psychosis-inducing drugs went up, while the sensitivity to anti-psychotic drugs went down,” said Weiner..
“This is exactly what we observe in women with low estrogen levels,” she said
They also found that taken alone estrogen combated psychosis in both male and female rats.
“Antipsychotic drugs are less effective during low periods of estrogen in the body, after birth and in menopause,” said Weiner.
Does HRT help schizophrenia in humans?
When combined with antipsychotic medications, the estrogen estradiol appears to be a useful treatment in women with schizophrenia.
A randomized, double-blind study involving 102 schizophrenic women of child-bearing age at the Monash University and The Alfred Hospital, Melbourne, Australia administered 100 micrograms of estradiol daily via a skin patch.
The report was published in the August 2009 issue of Archives of General Psychiatry.
For 28 days, 56 women were and 46 women received a placebo skin patch in addition to their regular medications. Psychotic symptoms, which include delusions and hallucinatory behavior, were assessed weekly on a scale.
Women taking estradiol exhibited a greater improvement in psychotic symptoms over time than did the women taking antipsychotic medications alone.
There was a decline in positive symptoms, which represent a distortion of normal functions, however no difference was observed with negative symptoms which occur when normal functions are lost or diminished.
Negative symptoms have been previously shown to be less responsive to treatment than other symptoms of schizophrenia.
“Estrogen’s neuroprotective and psychoprotective actions may be mediated by a variety of routes,” report led by Jayashri Kulkarni, of The Alfred Hospital including faster acting antioxidant effects, enhanced cerebral blood flow and cerebral glucose utilization or slowe, permanent modification of neural circuits.
