Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, School of Psychology and Psychiatry, Level One, Old Baker Building, Commercial Road, Melbourne 3004, Australia.
Schizophr Res. 2011 Feb;125(2-3):278-83. doi: 10.1016/j.schres.2010.10.009. Epub 2010 Nov 9.
Adjunctive use of estrogen therapy has been shown to be effective in enhancing the treatment of schizophrenia in women. In men, consideration of estrogen therapy has been impacted by concerns of feminising side effects, however, clinical trials of the use of estrogen in treating prostate cancer, bone density loss and even aggression and psychosis in dementia or traumatic brain injury, show this to be a safe and effective therapy. The current 14-day randomised placebo-controlled trial in 53 men with schizophrenia was conducted to evaluate the efficacy of 2 mg oral estradiol valerate as an adjunct to atypical antipsychotic treatment. Results demonstrated for estradiol participants a more rapid reduction in general psychopathology that occurred in the context of greater increases in serum estrogen levels and reductions in FSH and testosterone levels. Approximately 28% of estradiol participants did not achieve an increase (at least a 50% from baseline) in serum estrogen suggesting that further research is needed to refine the type, dose and administration route for estrogen therapy in men. Findings do, however, suggest further exploration of a therapeutic role for adjunctive estradiol treatment in men with schizophrenia is warranted.
雌激素治疗的辅助应用已被证明在增强女性精神分裂症的治疗方面是有效的。在男性中，由于担心出现女性化的副作用，对雌激素治疗的考虑受到了影响，然而，雌激素在治疗前列腺癌、骨密度丧失甚至痴呆或创伤性脑损伤中的攻击性和精神病方面的临床试验表明，这是一种安全有效的治疗方法。目前在 53 名男性精神分裂症患者中进行的为期 14 天的随机安慰剂对照试验旨在评估 2 毫克口服戊酸雌二醇作为辅助治疗非典型抗精神病药物的疗效。结果表明，对于接受雌二醇治疗的患者，一般精神病理学的改善更快，这是在血清雌激素水平升高、促卵泡激素和睾酮水平降低的情况下发生的。大约 28%的雌二醇组患者的血清雌激素水平没有增加（至少比基线增加 50%），这表明需要进一步研究，以确定男性雌激素治疗的类型、剂量和给药途径。然而，这些发现确实表明，有必要进一步探索辅助雌二醇治疗在男性精神分裂症患者中的治疗作用。
