Hormone Therapy for Schizophrenia?
Estrogen Patch Cuts Schizophrenia Symptoms
"Estrogen is very interesting. Besides its actions as a sex hormone, it plays many roles in the brain," Ongur tells WebMD. "We are going to be seeing more of this approach, spurred on by the Kulkarni studies and other papers."
However, Ongur warns that hormone therapy with estrogen is not benign. Estrogen has effects throughout the body -- including promotion of hormone-sensitive breast and cervical cancers.
That's why Kulkarni's team is exploring the use of a class of drugs called selective estrogen receptor modulators or SERMs. The idea is to see whether these drugs can exert the same antipsychotic effect as estrogen without estrogen's side effects.
Interestingly, adding estrogen to standard treatments also seems to help men with schizophrenia. In a two-week pilot study with 52 men -- kept brief to avoid the feminizing effects of female sex hormone -- Kulkarni's team found that estrogen reduced acute schizophrenia symptoms.
The researchers now plan a larger study of SERMs in men with schizophrenia. SERM trials in women with schizophrenia also are planned. Meanwhile, Kulkarni is focusing on a three-site study of estrogen patches in schizophrenic women of childbearing age. That study is designed to ensure that the current findings aren't a fluke.
Kulkarni says she is currently using estrogen to treat schizophrenia in women -- but only with ongoing Pap smears, breast exams, blood pressure tests, and other health checks.
Ongur warns families that while estrogen appears useful, much more work is needed to ensure that hormone therapy is both safe and effective.
"Patients and families should not be rushing to their psychiatrists and asking for estrogen patches," he says. "But they should watch the news coming out of this work carefully."
Kulkarni agrees that there's a lot more to be done before estrogen can be considered a safe addition to schizophrenia treatment.
"There is a lot to be done. But I believe that we have opened up a new and promising area of treatment for a debilitating illness in both women and men," she says.