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A Systematic Review of Estrogen Modulators as Augmentation to Antipsychotics for the Treatment of Post- and Perimenopausal Psychosis

Published online by Cambridge University Press:  01 August 2024

Cassidy Keen ,
Athanasios Hassoulas  and
Jill Richardson
Cassidy Keen*
Affiliation:
Brunel University London, London, United Kingdom Cardiff University, Cardiff, United Kingdom
Athanasios Hassoulas
Affiliation:
Cardiff University, Cardiff, United Kingdom
Jill Richardson
Affiliation:
Cardiff University, Cardiff, United Kingdom
*
*Presenting author.
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Abstract

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Aims

To investigate if estrogen agents as an adjunct to antipsychotic medication are effective at treating psychosis in post-and perimenopausal females.

Methods

A digital search focusing on controlled clinical trials was conducted. Studies were assessed for quality using the Cochrane Risk of Bias tool and GRADE system. The Joanna Briggs Institute (JBI) tools were used to critically appraise articles. The total Positive and Negative Symptom Scale (PANSS) scores were synthesised using a meta-analysis.

Results

Of the studies obtained (n = 11), two used estrogen HT as an augmentation agent, and nine used the SERM Raloxifene. Quality review and critical appraisal found inconsistencies in data and publication bias favouring trials that include Raloxifene. Meta-analysis results indicate Raloxifene plus antipsychotic did perform better than placebo [Std diff in means total = 0.340 (95% CI) p = 0.001] with a small effect size (g = 0.3392).

Conclusion

Though research appears promising, recommendations for the use of estrogen agent augmentation cannot be made at this time as more clinical trials that include a diverse range of treatments are needed.

Type
1 Research
Information
BJPsych Open , Volume 10 , Supplement S1: Abstracts from the RCPsych International Congress 2024, 17–20 June , June 2024 , pp. S50 - S51
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

Footnotes

Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.

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