Salokangas R K
Department of Psychiatry, University of Turku, Turku University Central Hospital, Finland.
Schizophr Res. 1995 Jul;16(1):7-16. doi: 10.1016/0920-9964(94)00059-h.
According to the oestrogen hypothesis, the lower need for neuroleptic drugs in female schizophrenics is caused by the antidopaminergic effect of oestrogens. Due to the decreased oestrogen production during the menopause, this 'neuroleptic' effect is lost and the need for neuroleptic drugs increases in female schizophrenics. This hypothesis was tested by studying a sample of 1097 schizophrenic patients (DSM-III-R), who were discharged from hospital and followed for three years. Prescribed daily doses of neuroleptic drugs were recorded and converted to chlorpromazine equivalents. Males had higher daily doses of neuroleptics than females; this gender difference, however, was only significant in middle-aged groups. Daily doses were also associated with age at the onset of illness, duration of illness and clinical status. Results did not support the oestrogen hypothesis: In females, there was no consistent increase in daily doses of neuroleptics after menopause age. Results are discussed from the viewpoint of testosterone secretion, body weight and smoking habits, which are gender-bound and thus can, at least in part, explain gender differences in the use of neuroleptic drugs in schizophrenic patients. It is pointed out that the age at the onset of illness and the duration of illness should be taken into account when the effects of gender and age on the need for neuroleptics are studied.
根据雌激素假说，女性精神分裂症患者对神经阻滞剂药物的需求较低是由雌激素的抗多巴胺能作用引起的。由于更年期期间雌激素分泌减少，这种“神经阻滞”作用丧失，女性精神分裂症患者对神经阻滞剂药物的需求增加。通过对1097名精神分裂症患者（DSM-III-R）的样本进行研究来检验这一假说，这些患者已出院并随访了三年。记录规定的每日神经阻滞剂药物剂量并换算为氯丙嗪等效剂量。男性的神经阻滞剂每日剂量高于女性；然而，这种性别差异仅在中年组中显著。每日剂量还与发病年龄、病程和临床状态相关。结果不支持雌激素假说：在女性中，绝经年龄后神经阻滞剂的每日剂量并没有持续增加。从睾酮分泌、体重和吸烟习惯的角度对结果进行了讨论，这些因素与性别相关，因此至少可以部分解释精神分裂症患者在使用神经阻滞剂药物方面的性别差异。有人指出，在研究性别和年龄对神经阻滞剂需求的影响时，应考虑发病年龄和病程。
