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Evidence summaries

Estrogen for Schizophrenia

Adjunctive estrogen with or without progesterone does not appear to offer advantages over placebo for the treatment of schizophrenia. Level of evidence: "B"

A Cochrane review [Abstract] 1 included four studies, with a total of 108 women, comparing estrogen only with placebo. Short-term scores for general mental state showed no significant difference between groups (n=24, 1 RCT, WMD PANSS for 100 mcg comparison -2.26, CI -15.4 to 10.9). Data from all four studies showed overall loss from the studies was low (~5%), with no significant differences between groups (n=96, 4 RCTs, RR 0.95, CI 0.2 to 6.1). One medium-term unpublished study (n=14) compared estrogen and progesterone with placebo. Data at six months showed no difference between groups for total scores (n=9, WMD PANSS -25.3, CI -51 to 0.1). For negative symptoms, results favoured the estrogen and progesterone group (n=9, WMD PANSS negative subscale -9.0, CI -17 to -0.9).

Comment: The quality of evidence is downgraded by imprecise data (limited study size for each comparison).

    References

    • Chua WL, de Izquierdo SA, Kulkarni J, Mortimer A. Estrogen for schizophrenia. Cochrane Database Syst Rev 2005 Oct 19;(4):CD004719. [PubMed]

Primary/Secondary Keywords