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雌激素——精神分裂症的一种新治疗方法?

Oestrogen--a new treatment approach for schizophrenia?

作者信息

Kulkarni Jayashri

机构信息

Alfred Psychiatry Research Centre, Monash University and Alfred Hospital, Melbourne, VIC.

出版信息

Med J Aust. 2009 Feb 16;190(S4):S37-8. doi: 10.5694/j.1326-5377.2009.tb02373.x.

Abstract

The oestrogen protection hypothesis proposes that oestrogen has a protective effect against onset of schizophrenia. In support of this: Epidemiological studies have shown that young women are less likely to develop schizophrenia than men of the same age, and women are more likely to develop late-onset schizophrenia after menopause. Clinical studies have shown higher psychotic symptoms in perimenopausal women, and women at the low oestrogen phase of the menstrual cycle. Animal studies provide further evidence in support of the oestrogen protection hypothesis. Three randomised double-blind placebo-controlled trials and an open-label study showed that adding oestradiol to women's usual antipsychotic medications was associated with significant abatement of schizophrenia symptoms. A small study of men with schizophrenia who received oral oestradiol valerate also showed a significant abatement in psychotic symptoms. Although oestrogen appears to be a useful treatment for schizophrenia, further research is required to determine the correct dose and duration of use of oestradiol. New types of oestrogen compounds may provide a safer, non-feminising approach for the treatment of schizophrenia.

摘要

雌激素保护假说提出,雌激素对精神分裂症的发病具有保护作用。支持这一观点的依据如下:流行病学研究表明,年轻女性患精神分裂症的可能性低于同龄男性,而女性在绝经后更易患迟发性精神分裂症。临床研究显示,围绝经期女性以及处于月经周期低雌激素阶段的女性存在更高的精神病性症状。动物研究为雌激素保护假说提供了进一步的证据。三项随机双盲安慰剂对照试验和一项开放标签研究表明,在女性常用抗精神病药物中添加雌二醇与精神分裂症症状的显著减轻相关。一项针对服用戊酸雌二醇的精神分裂症男性患者的小型研究也显示出精神病性症状的显著减轻。尽管雌激素似乎是治疗精神分裂症的一种有效方法,但仍需进一步研究以确定雌二醇的正确剂量和使用时长。新型雌激素化合物可能为精神分裂症的治疗提供一种更安全、无女性化作用的方法。

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