Department of Psychology, Tel-Aviv University, Tel-Aviv, Israel.
Neuropsychopharmacology. 2010 Jun;35(7):1570-82. doi: 10.1038/npp.2010.28. Epub 2010 Mar 17.
Women with schizophrenia have later onset and better response to antipsychotic drugs (APDs) than men during reproductive years, but the menopausal period is associated with increased symptom severity and reduced treatment response. Estrogen replacement therapy has been suggested as beneficial but clinical data are inconsistent. Latent inhibition (LI), the capacity to ignore irrelevant stimuli, is a measure of selective attention that is disrupted in acute schizophrenia patients and in rats and humans treated with the psychosis-inducing drug amphetamine and can be reversed by typical and atypical APDs. Here we used amphetamine (1 mg/kg)-induced disrupted LI in ovariectomized rats to model low levels of estrogen along with hyperfunction of the dopaminergic system that may be occurring in menopausal psychosis, and tested the efficacy of APDs and estrogen in reversing disrupted LI. 17beta-Estradiol (50, 150 microg/kg), clozapine (atypical APD; 5, 10 mg/kg), and haloperidol (typical APD; 0.1, 0.3 mg/kg) effectively reversed amphetamine-induced LI disruption in sham rats, but were much less effective in ovariectomized rats; 17beta-estradiol and clozapine were effective only at high doses (150 microg/kg and 10 mg/kg, respectively), whereas haloperidol failed at both doses. Haloperidol and clozapine regained efficacy if coadministered with 17beta-estradiol (50 microg/kg, an ineffective dose). Reduced sensitivity to dopamine (DA) blockade coupled with spared/potentiated sensitivity to DA stimulation after ovariectomy may provide a novel model recapitulating the combination of increased vulnerability to psychosis with reduced response to APD treatment in female patients during menopause. In addition, our data show that 17beta-estradiol exerts antipsychotic activity.
患有精神分裂症的女性在生育期比男性的发病晚且对 抗精神病药物(APD)的反应更好,但更年期与症状加重和治疗反应降低有关。已有人提出雌激素替代疗法有益,但临床数据不一致。潜伏抑制(LI)是忽略无关刺激的能力,是选择性注意的一种衡量标准,在急性精神分裂症患者以及用致精神病药物安非他命治疗的大鼠和人类中受到干扰,并且可以被典型和非典型的 APD 逆转。在这里,我们使用安非他命(1mg/kg)诱导的去卵巢大鼠 LI 破坏来模拟雌激素水平低和多巴胺能系统功能亢进,这可能发生在更年期精神病中,并测试了 APD 和雌激素逆转 LI 破坏的疗效。17β-雌二醇(50、150μg/kg)、氯氮平(非典型 APD;5、10mg/kg)和氟哌啶醇(典型 APD;0.1、0.3mg/kg)有效地逆转了假手术大鼠的安非他命诱导的 LI 破坏,但在去卵巢大鼠中效果要差得多;17β-雌二醇和氯氮平仅在高剂量(分别为 150μg/kg 和 10mg/kg)时有效,而氟哌啶醇在两种剂量下均无效。如果与 17β-雌二醇(50μg/kg,无效剂量)联合给药,氟哌啶醇和氯氮平可恢复疗效。去卵巢后多巴胺(DA)阻断敏感性降低,同时对 DA 刺激的敏感性增加或增强,这可能为女性患者在更年期时易患精神病且对 APD 治疗反应降低的组合提供了一种新的模型。此外,我们的数据表明,17β-雌二醇具有抗精神病作用。