Bodyl A. Brand, Janna N. de Boer, Elske J. M. Willemse, Cynthia S. Weickert, Iris E. Sommer, Thomas W. Weickert
{"title":"抗精神病药物诱发绝经前精神分裂症女性催乳素升高：与雌激素、疾病严重程度和认知能力的关系。","authors":"Bodyl A. Brand, Janna N. de Boer, Elske J. M. Willemse, Cynthia S. Weickert, Iris E. Sommer, Thomas W. Weickert","doi":"10.1007/s00737-024-01491-9","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>Antipsychotic-induced prolactin elevation may impede protective effects of estrogens in women with schizophrenia-spectrum disorders (SSD). Our study sought to confirm whether the use of prolactin-raising antipsychotics is associated with lower estrogen levels, and to investigate how estrogen and prolactin levels relate to symptom severity and cognition in premenopausal women with SSD.</p><h3>Methods</h3><p>This cross-sectional study included 79 premenopausal women, divided in three groups of women with SSD treated with prolactin-sparing antipsychotics (<i>n =</i> 21) or prolactin-raising antipsychotics (<i>n =</i> 27), and age-matched women without SSD (<i>n =</i> 31). Circulating 17β-estradiol was compared among groups. In patients, we assessed the relationship between prolactin and 17β-estradiol, and the relationships of these hormones to symptom severity and cognition, using correlation analyses and backward regression models.</p><h3>Results</h3><p>In women receiving prolactin-raising antipsychotics, 17β-estradiol levels were lower as compared to both other groups (<i>H(</i>2) = 8.34; <i>p</i> = 0.015), and prolactin was inversely correlated with 17β-estradiol (<i>r</i>=-0.42, <i>p</i> = 0.030). In the prolactin-raising group, 17β-estradiol correlated positively with verbal fluency (<i>r</i> = 0.52, <i>p</i> = 0.009), and 17β-estradiol and prolactin together explained 29% of the variation in processing speed (<i>β</i><sub>17β−estradiol</sub> = 0.24, <i>β</i><sub>prolactin </sub>= -0.45, <i>F</i>(2,25) = 5.98, <i>p</i> = 0.008). In the prolactin-sparing group, 17β-estradiol correlated negatively with depression/anxiety (<i>r </i>= -0.57, <i>p</i> = 0.014), and together with prolactin explained 26% of the variation in total symptoms (<i>β</i><sub>17β−estradiol</sub> = -0.41, <i>β</i><sub>prolactin</sub> = 0.32, <i>F</i>(2,18) = 4.44, <i>p</i> = 0.027).</p><h3>Conclusions</h3><p>In women with SSD, antipsychotic-induced prolactin elevation was related to lower estrogen levels. Further, estrogens negatively correlated with symptom severity and positively with cognition, whereas prolactin levels correlated negatively with cognition. Our findings stress the clinical importance of maintaining healthy levels of prolactin and estrogens in women with SSD.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"27 6","pages":"931 - 941"},"PeriodicalIF":3.2000,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00737-024-01491-9.pdf","citationCount":"0","resultStr":"{\"title\":\"Antipsychotic-induced prolactin elevation in premenopausal women with schizophrenia: associations with estrogen, disease severity and cognition\",\"authors\":\"Bodyl A. Brand, Janna N. de Boer, Elske J. M. Willemse, Cynthia S. Weickert, Iris E. Sommer, Thomas W. Weickert\",\"doi\":\"10.1007/s00737-024-01491-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>Antipsychotic-induced prolactin elevation may impede protective effects of estrogens in women with schizophrenia-spectrum disorders (SSD). Our study sought to confirm whether the use of prolactin-raising antipsychotics is associated with lower estrogen levels, and to investigate how estrogen and prolactin levels relate to symptom severity and cognition in premenopausal women with SSD.</p><h3>Methods</h3><p>This cross-sectional study included 79 premenopausal women, divided in three groups of women with SSD treated with prolactin-sparing antipsychotics (<i>n =</i> 21) or prolactin-raising antipsychotics (<i>n =</i> 27), and age-matched women without SSD (<i>n =</i> 31). Circulating 17β-estradiol was compared among groups. In patients, we assessed the relationship between prolactin and 17β-estradiol, and the relationships of these hormones to symptom severity and cognition, using correlation analyses and backward regression models.</p><h3>Results</h3><p>In women receiving prolactin-raising antipsychotics, 17β-estradiol levels were lower as compared to both other groups (<i>H(</i>2) = 8.34; <i>p</i> = 0.015), and prolactin was inversely correlated with 17β-estradiol (<i>r</i>=-0.42, <i>p</i> = 0.030). In the prolactin-raising group, 17β-estradiol correlated positively with verbal fluency (<i>r</i> = 0.52, <i>p</i> = 0.009), and 17β-estradiol and prolactin together explained 29% of the variation in processing speed (<i>β</i><sub>17β−estradiol</sub> = 0.24, <i>β</i><sub>prolactin </sub>= -0.45, <i>F</i>(2,25) = 5.98, <i>p</i> = 0.008). In the prolactin-sparing group, 17β-estradiol correlated negatively with depression/anxiety (<i>r </i>= -0.57, <i>p</i> = 0.014), and together with prolactin explained 26% of the variation in total symptoms (<i>β</i><sub>17β−estradiol</sub> = -0.41, <i>β</i><sub>prolactin</sub> = 0.32, <i>F</i>(2,18) = 4.44, <i>p</i> = 0.027).</p><h3>Conclusions</h3><p>In women with SSD, antipsychotic-induced prolactin elevation was related to lower estrogen levels. Further, estrogens negatively correlated with symptom severity and positively with cognition, whereas prolactin levels correlated negatively with cognition. Our findings stress the clinical importance of maintaining healthy levels of prolactin and estrogens in women with SSD.</p></div>\",\"PeriodicalId\":8369,\"journal\":{\"name\":\"Archives of Women's Mental Health\",\"volume\":\"27 6\",\"pages\":\"931 - 941\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-07-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1007/s00737-024-01491-9.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Women's Mental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s00737-024-01491-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Women's Mental Health","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s00737-024-01491-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Antipsychotic-induced prolactin elevation in premenopausal women with schizophrenia: associations with estrogen, disease severity and cognition
Purpose
Antipsychotic-induced prolactin elevation may impede protective effects of estrogens in women with schizophrenia-spectrum disorders (SSD). Our study sought to confirm whether the use of prolactin-raising antipsychotics is associated with lower estrogen levels, and to investigate how estrogen and prolactin levels relate to symptom severity and cognition in premenopausal women with SSD.
Methods
This cross-sectional study included 79 premenopausal women, divided in three groups of women with SSD treated with prolactin-sparing antipsychotics (n = 21) or prolactin-raising antipsychotics (n = 27), and age-matched women without SSD (n = 31). Circulating 17β-estradiol was compared among groups. In patients, we assessed the relationship between prolactin and 17β-estradiol, and the relationships of these hormones to symptom severity and cognition, using correlation analyses and backward regression models.
Results
In women receiving prolactin-raising antipsychotics, 17β-estradiol levels were lower as compared to both other groups (H(2) = 8.34; p = 0.015), and prolactin was inversely correlated with 17β-estradiol (r=-0.42, p = 0.030). In the prolactin-raising group, 17β-estradiol correlated positively with verbal fluency (r = 0.52, p = 0.009), and 17β-estradiol and prolactin together explained 29% of the variation in processing speed (β17β−estradiol = 0.24, βprolactin = -0.45, F(2,25) = 5.98, p = 0.008). In the prolactin-sparing group, 17β-estradiol correlated negatively with depression/anxiety (r = -0.57, p = 0.014), and together with prolactin explained 26% of the variation in total symptoms (β17β−estradiol = -0.41, βprolactin = 0.32, F(2,18) = 4.44, p = 0.027).
Conclusions
In women with SSD, antipsychotic-induced prolactin elevation was related to lower estrogen levels. Further, estrogens negatively correlated with symptom severity and positively with cognition, whereas prolactin levels correlated negatively with cognition. Our findings stress the clinical importance of maintaining healthy levels of prolactin and estrogens in women with SSD.
期刊介绍：
Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.
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