Women and Schizophrenia: Sex-Based Pharmacotherapy

Sex-based pharmacotherapy is a new research and clinical area which could be characterized by the inclusion of sex-related variables in clinical, research and educational issues with respect to pharmacotherapy. In this article we will review the studies that evaluate the treatment of schizophrenia with respect to sex considerations. First we will report the findings about sex differences in response to treatment: pharmacokinetic sex differences and differences in effectiveness of response to antipsychotics. We will further review the studies that evaluate the use of estrogens as an adjuvant treatment in women with schizophrenia: in patients with premenstrual worsening of symptoms or in resistant forms of the illness. Also, the possible use of raloxifene (a selective estrogen receptor modulator) as an adjuvant treatment in some postmenopausal schizophrenic women will be discussed. Finally we will review the endocrinal/sexual adverse effects of antipsychotics in women.