Background:
Estrogen modulates rat brain dopamine and serotonin systems in a way that mimics atypical antipsychotics. Our work indicates that adjunctive estrogen is a useful treatment in women of childbearing age with schizophrenia. We studied the use of a selective estrogen receptor modulator (SERM) in meno-pausal women with schizophrenia.
Aim:
To test and compare the effects of adjunctive use of an SERM (raloxifene) and standard hormone therapy (HT) on psychotic symptoms in menopausal women with schizophrenia. To examine the effect of an SERM and HT on cognition in menopausal women with schizophrenia.
Method:
A double-blind, 3-month, placebo-controlled, adjunctive study of raloxifene (60 mg/day) vs. HT (2 mg estradiol plus 10 mg dihydroprogesterone) vs. placebo was conducted. Participants received standardized doses of risperidone (or equivalent doses of similar antipsychotic medication). Psychopathology was measured fortnightly using the Positive and Negative Syndrome Scale rating scale. Cognitive testing and sex hormone assays were conducted monthly.
Results:
Data collected from 23 participants indicated that while SERM or HT adjuncts did not result in an improvement in psychotic symptoms when compared with risperidone alone, the use of adjunctive SERM resulted in improved cognitive performance on working and verbal memory tasks when compared with the HT or risperidone alone.
Conclusions:
The use of adjunctive SERM at 60 mg/day may induce a mild increase in cognitive performance in menopausal women with schizophrenia. Yaffe et al. (2005) show that 120 mg/day raloxifene was more effective in improving cognition in healthy postmenopausal women. We are undertaking a new study with this increased dose of raloxifene.
