By Anne Harding

NEW YORK — Women with schizophrenia may benefit from hormone therapy (HT) during menopause, and may also need adjustments to their antipsychotic drug regimen, according to a new research review.

"Both hormone therapy and changes in antipsychotic management should be considered for women with schizophrenia at menopause," Dr. Amnon Brzezinski of The Hebrew University-Hadassah Medical Center in Jerusalem told Reuters Health by email.

Estrogen has been proposed to play a role in some of the well-known gender differences in schizophrenia, Dr. Brzezinski and his colleagues note in Menopause, online November 7.

"The main differences are: Later appearance of the disease in women (at adolescence), milder course of the disease in women, better response of women to antipsychotic therapy, and a second peak of the disease at menopause," the researcher explained.

To investigate whether HT is beneficial for schizophrenia patients during menopause, the researchers looked at 62 reviews and studies published between 1990 and 2016.

A small study suggested that HT improved negative symptoms in postmenopausal women with schizophrenia, while another found that HT users were on a lower average dose of antipsychotic medication compared to non-users. However, studies of raloxifine have had mixed results.

It's unclear, the authors note, whether HT improves mood or cognition in menopausal women with schizophrenia.

Given the changes in drug metabolism during menopause, Dr. Brzezinski and his team add, clinicians treating women with schizophrenia during menopause should periodically review medication regimens.

"Women with schizophrenia suffer from menopausal symptoms as frequently as healthy women," Dr. Brzezinski said. "Hormone therapy during the perimenopause in schizophrenic women ameliorates psychotic, and cognitive symptoms and may also help affective symptoms. Vasomotor, genito-urinary, and sleep symptoms are also reduced."

However, he added, women with schizophrenia are less likely to be offered HT for their menopausal symptoms.

Dr. Brzezinski said he and his colleagues hope to improve collaboration among psychiatrists and gynecologists so that women with schizophrenia can receive effective treatment for menopausal symptoms.

SOURCE: http://bit.ly/2fLlbFe

Menopause 2016.

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