3b116d3ed358236fc93c3bf8bb804339 pmc_34575626.pdf b3a132560e94e434c8a9ade4798714677be08ba7 pmc_34575626.pdf 6d6b6d50f25af79e984074b57eefd72ceb635ac01875f6e3fe251b8b0a3f73fa pmc_34575626.pdf Title: Peri- and Post-Menopausal Women with Schizophrenia and Related Disorders Are a Population with Specific Needs: A Narrative Review of Current Theories Subject: Background: While gender differences in antipsychotic response have been recognized, the potential role of menopause in changing drug efficacy and clinical outcome in schizophrenia related disorders has been understudied. We aimed to review the relevant literature to test whether optimizing menopausal and post-menopausal treatment and addressing specific health needs of this stage in life will improve outcome. Methods: Non-systematic narrative review using the PubMed database (1900–July 2021) focusing on randomized controlled trial results addressing our question. Forty-nine studies met our criteria. Results: Premenopausal women show significantly better antipsychotic response than postmenopausal women. Hormone replacement therapies (HRT) should be used in postmenopausal women with schizophrenia with caution. Raloxifene, combined with antipsychotics, is effective for psychotic and cognitive symptoms in postmenopausal women with schizophrenia and related disorders. Medical comorbidities increase after menopause, but the influence of comorbidities on clinical outcomes has been poorly investigated. Preventive strategies include weighing risks and benefits of treatment, preventing medical comorbidities, and enhancing psychosocial support. Ideal treatment settings for this population warrant investigation. Conclusions: Antipsychotic dose adjustment at menopause is recommended for schizophrenia. Raloxifene may play an important role in permitting dose reduction and lessening adverse effects. Prevention of comorbidities will help to reduce the mortality rate. Keywords: schizophrenia; menopause; hormones; antipsychotics; comorbidity Author: Alexandre González-Rodríguez, Armand Guàrdia and José Antonio Monreal Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Sep 9 07:58:23 2021 CEST ModDate: Thu Sep 9 08:07:26 2021 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 18 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 737511 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- LVQZGQ+URWPalladioL-Ital Type 1 Custom yes yes no 10 0 SLSVYZ+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 GKTDVJ+URWPalladioL-Roma Type 1 Custom yes yes no 19 0 VJNASK+VnURWPalladioL-Bold Type 1 Custom yes yes no 23 0 NLQXLE+VnURWPalladioL Type 1 Custom yes yes no 28 0 UIJACC+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 BPLGMI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 87 0 BPLGMK+PalatinoLinotype TrueType WinAnsi yes yes no 90 0 BPLGNL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 93 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-11-23 05:27:37 CET RepresentationInformation: pmc_34575626.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:05:46 CEST Size: 737511 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 419 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Methods Destination: section.2 Item: Title: Results Destination: section.3 Children: Item: Title: Choice of Antipsychotics in Postmenopausal Women with Schizophrenia and Related Disorders Destination: subsection.3.1 Item: Title: Antipsychotic Dose Adjustment in Postmenopausal Women with Schizophrenia and Related Disorders Destination: subsection.3.2 Item: Title: Hormone Replacement Therapy in Postmenopausal Women with Schizophrenia Destination: subsection.3.3 Item: Title: Selective Estrogen Receptor Modulators for the Treatment of Postmenopausal Women with Schizophrenia and Related Disorders Destination: subsection.3.4 Item: Title: Influence of Menopausal Symptoms and Comorbidities on Treatment Outcomes in Schizophrenia and Related Disorders Destination: subsection.3.5 Item: Title: Family Stress, Psychopathological Symptoms, and Clinical Outcomes in Postmenopausal Women with Schizophrenia Destination: subsection.3.6 Item: Title: Specialized Care Settings for Peri- and Post-Menopausal Women with Schizophrenia Destination: subsection.3.7 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Peri- and Post-Menopausal Women with Schizophrenia and Related Disorders Are a Population with Specific Needs: A Narrative Review of Current Theories Author: Alexandre González-Rodríguez, Armand Guàrdia and José Antonio Monreal Subject: Background: While gender differences in antipsychotic response have been recognized, the potential role of menopause in changing drug efficacy and clinical outcome in schizophrenia related disorders has been understudied. We aimed to review the relevant literature to test whether optimizing menopausal and post-menopausal treatment and addressing specific health needs of this stage in life will improve outcome. Methods: Non-systematic narrative review using the PubMed database (1900 July 2021) focusing on randomized controlled trial results addressing our question. Forty-nine studies met our criteria. Results: Premenopausal women show significantly better antipsychotic response than postmenopausal women. Hormone replacement therapies (HRT) should be used in postmenopausal women with schizophrenia with caution. Raloxifene, combined with antipsychotics, is effective for psychotic and cognitive symptoms in postmenopausal women with schizophrenia and related disorders. Medical comorbidities increase after menopause, but the influence of comorbidities on clinical outcomes has been poorly investigated. Preventive strategies include weighing risks and benefits of treatment, preventing medical comorbidities, and enhancing psychosocial support. Ideal treatment settings for this population warrant investigation. Conclusions: Antipsychotic dose adjustment at menopause is recommended for schizophrenia. Raloxifene may play an important role in permitting dose reduction and lessening adverse effects. Prevention of comorbidities will help to reduce the mortality rate. 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