Top

Current Psychiatry Reports

Published in:

Open Access 21-10-2023 | Aripiprazole

Evidence-Based Recommendations for the Pharmacological Treatment of Women with Schizophrenia Spectrum Disorders

Authors: Bodyl A. Brand, Elske J. M. Willemse, Iris M. H. Hamers, Iris E. Sommer

Published in: Current Psychiatry Reports | Issue 11/2023

Abstract

Purpose of Review

Despite clear evidence that sex differences largely impact the efficacy and tolerability of antipsychotic medication, current treatment guidelines for schizophrenia spectrum disorders (SSD) do not differentiate between men and women. This review summarizes the available evidence on strategies that may improve pharmacotherapy for women and provides evidence-based recommendations to optimize treatment for women with schizophrenia.

Recent Findings

We systematically searched PubMed and Embase for peer-reviewed studies on three topics: (1) sex differences in dose-adjusted antipsychotic serum concentrations, (2) hormonal augmentation therapy with estrogen and estrogen-like compounds to improve symptom severity, and (3) strategies to reduce antipsychotic-induced hyperprolactinemia. Based on three database studies and one RCT, we found higher dose-adjusted concentrations in women compared to men for most antipsychotics. For quetiapine, higher concentrations were specifically found in older women. Based on two recent meta-analyses, both estrogen and raloxifene improved overall symptomatology. Most consistent findings were found for raloxifene augmentation in postmenopausal women. No studies evaluated the effects of estrogenic contraceptives on symptoms. Based on two meta-analyses and one RCT, adjunctive aripiprazole was the best-studied and safest strategy for lowering antipsychotic-induced hyperprolactinemia.

Summary

Evidence-based recommendations for female-specific pharmacotherapy for SSD consist of (1) female-specific dosing for antipsychotics (guided by therapeutic drug monitoring), (2) hormonal replacement with raloxifene in postmenopausal women, and (3) aripiprazole addition as best evidenced option in case of antipsychotic-induced hyperprolactinemia. Combining these strategies could reduce side effects and improve outcome of women with SSD, which should be confirmed in future longitudinal RCTs.

Available only for authorised users

Kahn RS, Fleischhacker WW, Boter H, et al. Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet. 2008;371(9618):1085–97. https://doi.org/10.1016/S0140-6736(08)60486-9.CrossRefPubMed

Thomas N, Gurvich C, Hudaib AR, Gavrilidis E, Kulkarni J. Dissecting the syndrome of schizophrenia: associations between symptomatology and hormone levels in women with schizophrenia. Psychiatry Res. 2019. https://doi.org/10.1016/J.PSYCHRES.2019.112510.CrossRefPubMedPubMedCentral

Thompson K, Sergejew A, Kulkarni J. Estrogen affects cognition in women with psychosis. Psychiatry Res. 2000. https://doi.org/10.1016/S0165-1781(00)00161-X.CrossRefPubMed

Seeman MV. Secondary effects of antipsychotics: women at greater risk than men. Schizophr Bull. 2009;35(5):937–48. https://doi.org/10.1093/schbul/sbn023.CrossRefPubMed

Riecher-Rössler A. Estrogens and schizophrenia. In: Estrogen Effects in Psychiatric Disorders. Springer-Verlag; 2005:31–52. https://doi.org/10.1007/3-211-27063-9_2.

Riecher-Rössler A, Häfner H. Schizophrenia and oestrogens - is there an association? Eur Arch Psychiatry Clin Neurosci. 1993. https://doi.org/10.1007/BF02190244.CrossRefPubMed

Riecher-Rössler A, Häfner H, Maurer K, Stummbaum M, Schmidt R. Schizophrenic symptomatology varies with serum estradiol levels during menstrual cycle. Schizophr Res. 1992. https://doi.org/10.1016/0920-9964(92)90146-v.CrossRefPubMed

NICE. Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care. 2014. http://www.nice.org.uk/guidance/cg178. Accessed 12 Apr 2021.

Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB. The schizophrenia patient outcomes research team (PORT): updated treatment recommendations 2009. Schizophr Bull. 2010;36(1):94–103. https://doi.org/10.1093/SCHBUL/SBP130.CrossRefPubMed

10.

Gaebel W, Riesbeck M, Wobrock T. Schizophrenia guidelines across the world: a selective review and comparison. Int Rev Psychiatry. 2011;23(4):379–87. https://doi.org/10.3109/09540261.2011.606801.CrossRefPubMed

11.

Kuipers E, Yesufu-Udechuku A, Taylor C, Kendall T. Management of psychosis and schizophrenia in adults: summary of updated NICE guidance. BMJ. 2014. https://doi.org/10.1136/BMJ.G1173.CrossRefPubMed

12.

Crockford D, Addington D. Canadian schizophrenia guidelines: schizophrenia and other psychotic disorders with coexisting substance use disorders. Can J Psychiatry. 2017;62(9):624–34. https://doi.org/10.1177/0706743717720196.CrossRefPubMedPubMedCentral

13.

Hadjulis M, Margariti M, Lazaridou M, et al. Clinical guidelines for the management of schizophrenia: pharmacological and psychological interventions (III). Psychiatriki. 2018;29(4):303–15. https://doi.org/10.22365/JPSYCH.2018.294.303.CrossRefPubMed

14.

Huhn M, Nikolakopoulou A, Schneider-Thoma J, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet. 2019;394(10202):939–51. https://doi.org/10.1016/S0140-6736(19)31135-3.CrossRefPubMedPubMedCentral

15.

Alexopoulos GS, Streim J, Carpenter D, Docherty JP. Using antipsychotic agents in older patients. J Clin Psychiatry. 2004;65(Suppl 2).

16.

Lecomte T, Abidi S, Garcia-Ortega I, et al. Canadian treatment guidelines on psychosocial treatment of schizophrenia in children and youth. Can J Psychiatry. 2017;62(9):648–55. https://doi.org/10.1177/0706743717720195.CrossRefPubMedPubMedCentral

17.

Brand BA, Haveman YRA, De Beer F, De Boer JN, Dazzan P, Sommer IEC. Antipsychotic medication for women with schizophrenia spectrum disorders. Psychol Med. 2022;52(4):649–63. https://doi.org/10.1017/S0033291721004591.CrossRefPubMed

18.

Iversen TSJ, Steen NE, Dieset I, et al. Side effect burden of antipsychotic drugs in real life – impact of gender and polypharmacy. Prog Neuropsychopharmacol Biol Psychiatry. 2018;82:263–71. https://doi.org/10.1016/j.pnpbp.2017.11.004.CrossRefPubMed

19.

Keepers GA, Fochtmann LJ, Anzia JM, et al. The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry. 2020;177(9):868–72. https://doi.org/10.1176/APPI.AJP.2020.177901.CrossRefPubMed

20.

Ventriglio A, Ricci F, Magnifico G, et al. Psychosocial interventions in schizophrenia: focus on guidelines. Int J Soc Psychiatry. 2020;66(8):735–47. https://doi.org/10.1177/0020764020934827.CrossRefPubMed

21.

Kulkarni J, Butler S, Riecher-Rössler A. Estrogens and SERMS as adjunctive treatments for schizophrenia. Front Neuroendocrinol. 2019;53:100743. https://doi.org/10.1016/j.yfrne.2019.03.002.CrossRefPubMed

22.

• Reilly TJ, Sagnay de la Bastida VC, Joyce DW, Cullen AE, McGuire P. Exacerbation of psychosis during the perimenstrual phase of the menstrual cycle: systematic review and meta-analysis. Schizophr Bull. 2020;46(1):78–90. https://doi.org/10.1093/schbul/sbz030. This systematic review and meta-analysis showed that psychotic admission rates are significantly higher than expected during the perimenstrual phase of the menstrual cycle.

23.

Riecher-Rössler A. Oestrogens, prolactin, hypothalamic-pituitary-gonadal axis, and schizophrenic psychoses. Lancet Psychiatry. 2017;4(1):63–72. https://doi.org/10.1016/S2215-0366(16)30379-0.CrossRefPubMed

24.

Sommer IE, Brand BA, Gangadin S, Tanskanen A, Tiihonen J, Taipale H. Women with schizophrenia-spectrum disorders after menopause: a vulnerable group for relapse. Schizophr Bull. 2022. https://doi.org/10.1093/schbul/sbac139.CrossRefPubMedPubMedCentral

25.

Begemann MJH, Dekker CF, van Lunenburg M, Sommer IE. Estrogen augmentation in schizophrenia: a quantitative review of current evidence. Schizophr Res. 2012;141(2–3):179–84. https://doi.org/10.1016/j.schres.2012.08.016.CrossRefPubMed

26.

Heringa SM, Begemann MJH, Goverde AJ, Sommer IEC. Sex hormones and oxytocin augmentation strategies in schizophrenia: a quantitative review. Schizophr Res. 2015;168(3):603–13. https://doi.org/10.1016/j.schres.2015.04.002.CrossRefPubMed

27.

Lewis CA, Kimmig ACS, Zsido RG, Jank A, Derntl B, Sacher J. Effects of hormonal contraceptives on mood: a focus on emotion recognition and reactivity, reward processing, and stress response. Curr Psychiatry Rep. 2019. https://doi.org/10.1007/s11920-019-1095-z.CrossRefPubMedPubMedCentral

28.

Pinsky PF, Miller EA, Heckman-Stoddard BM, Minasian L. Breast cancer characteristics and survival among users versus nonusers of raloxifene. Cancer Prev Res. 2020;13(1):83–90. https://doi.org/10.1158/1940-6207.CAPR-19-0393.CrossRef

29.

Barrett-Connor E, Mosca L, Collins P, et al. Effects of raloxifene on cardiovascular events and breast cancer in postmenopausal women. N Engl J Med. 2006;355(2):125–37. https://doi.org/10.1056/NEJMoa062462.CrossRefPubMed

30.

Ellis AJ, Hendrick VM, Williams R, Komm BS. Selective estrogen receptor modulators in clinical practice: a safety overview. Expert Opin Drug Saf. 2015;14(6):921–34. https://doi.org/10.1517/14740338.2015.1014799.CrossRefPubMed

31.

Bushe C, Shaw M, Peveler RC. A review of the association between antipsychotic use and hyperprolactinaemia. J Psychopharmacol. 2008;22(2 Suppl):46–55. https://doi.org/10.1177/0269881107088435.CrossRefPubMed

32.

Smith SM, O’Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry. 2002;181(JULY):49–55. https://doi.org/10.1192/BJP.181.1.49.CrossRefPubMed

33.

Khan MM. Translational significance of selective estrogen receptor modulators in psychiatric disorders. Int J Endocrinol. 2018;2018:9516592. https://doi.org/10.1155/2018/9516592.CrossRefPubMedPubMedCentral

34.

Brand BA, de Boer JN, Sommer IEC. Estrogens in schizophrenia: progress, current challenges and opportunities. Curr Opin Psychiatry. 2021;34(3):228–37. https://doi.org/10.1097/YCO.0000000000000699.CrossRefPubMedPubMedCentral

35.

Taipale H, Solmi M, Lähteenvuo M, Tanskanen A, Correll CU, Tiihonen J. Antipsychotic use and risk of breast cancer in women with schizophrenia: a nationwide nested case-control study in Finland. Lancet Psychiatry. 2021;8(10):883–91. https://doi.org/10.1016/S2215-0366(21)00241-8.CrossRefPubMed

36.

O’Keane V. Antipsychotic-induced hyperprolactinaemia, hypogonadism and osteoporosis in the treatment of schizophrenia. J Psychopharmacol. 2008;22(2 Suppl):70–5. https://doi.org/10.1177/0269881107088439.CrossRefPubMed

37.

Meaney AM, Smith S, Howes OD, O’Brien M, Murray RM, O’Keane V. Effects of long-term prolactin-raising antipsychotic medication on bone mineral density in patients with schizophrenia. Br J Psychiatry. 2004;184(JUNE):503–8. https://doi.org/10.1192/BJP.184.6.503.CrossRefPubMed

38.

Lu D, Song J, Lu Y, et al. A shared genetic contribution to breast cancer and schizophrenia. Nat Commun. 2020. https://doi.org/10.1038/S41467-020-18492-8.CrossRefPubMedPubMedCentral

39.

Montejo ÁL, Arango C, Bernardo M, et al. Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics. Front Neuroendocrinol. 2017;45:25–34. https://doi.org/10.1016/J.YFRNE.2017.02.003.CrossRefPubMed

40.

Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs. 2004;64(20):2291–314. https://doi.org/10.2165/00003495-200464200-00003.CrossRefPubMed

41.

• Lu Z, Sun Y, Zhang Y, et al. Pharmacological treatment strategies for antipsychotic-induced hyperprolactinemia: a systematic review and network meta-analysis. Transl Psychiatry. 2022;12(1):267. https://doi.org/10.1038/s41398-022-02027-4. These comprehensive systematic review and network meta-analysis summarize studies on the efficacy of switching and adjunctive strategies for antipsychotic-induced prolactin elevation.CrossRefPubMedPubMedCentral

42.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339(1):b2535–b2535. https://doi.org/10.1136/bmj.b2535.CrossRefPubMedPubMedCentral

43.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. (DSM-IV). American Psychiatric Association. 1994. https://doi.org/10.1176/ajp.152.8.1228.

44.

ICD-10 Version:2010. https://icd.who.int/browse10/2010/en. Accessed 23 Feb 2023.

45.

• Jönsson AK, Spigset O, Reis M. A compilation of serum concentrations of 12 antipsychotic drugs in a therapeutic drug monitoring setting. Ther Drug Monit. 2019;41(3):348–56. https://doi.org/10.1097/FTD.0000000000000585. Large therapeutic drug monitoring study showing that women have significantly higher plasma concentrations than men for most antipsychotic drugs.CrossRefPubMed

46.

Castberg I, Westin AA, Skogvoll E, Spigset O. Effects of age and gender on the serum levels of clozapine, olanzapine, risperidone, and quetiapine. Acta Psychiatr Scand. 2017;136(5):455–64. https://doi.org/10.1111/acps.12794.CrossRefPubMed

47.

Hoekstra S, Bartz-Johannessen C, Sinkeviciute I, et al. Sex differences in antipsychotic efficacy and side effects in schizophrenia spectrum disorder: results from the BeSt InTro study. NPJ Schizophr. 2021;7(1):39. https://doi.org/10.1038/s41537-021-00170-3.CrossRefPubMedPubMedCentral

48.

Tveito M, Høiseth G, Haslemo T, Molden E, Smith RL. Impact of age and gender on paliperidone exposure in patients after administration of long-acting injectable formulations-an observational study using blood samples from 1223 patients. Eur J Clin Pharmacol. 2021;77(8):1201–8. https://doi.org/10.1007/S00228-021-03114-Z.CrossRefPubMed

49.

Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261–76. https://doi.org/10.1093/schbul/13.2.261.CrossRefPubMed

50.

Louzã MR, Marques AP, Elkis H, Bassitt D, Diegoli M, Gattaz WF. Conjugated estrogens as adjuvant therapy in the treatment of acute schizophrenia: a double-blind study. Schizophr Res. 2004. https://doi.org/10.1016/S0920-9964(03)00082-3.CrossRefPubMed

51.

• de Boer J, Prikken M, Lei WU, Begemann M, Sommer I. The effect of raloxifene augmentation in men and women with a schizophrenia spectrum disorder: a systematic review and meta-analysis. NPJ Schizophr. 2018;4(1):1. https://doi.org/10.1038/s41537-017-0043-3. Comprehensive meta-analysis on the efficacy of raloxifene in schizophrenia-spectrum disorders.CrossRefPubMedPubMedCentral

52.

Wang Q, Dong X, Wang Y, Li X. Raloxifene as an adjunctive treatment for postmenopausal women with schizophrenia: a meta-analysis of randomized controlled trials. Arch Womens Ment Health. 2018;21(1):31–41. https://doi.org/10.1007/s00737-017-0773-2.CrossRefPubMed

53.

Zhu XM, Zheng W, Li XH, et al. Adjunctive raloxifene for postmenopausal women with schizophrenia: a meta-analysis of randomized, double-blind, placebo-controlled trials. Schizophr Res. 2018;197:288–93. https://doi.org/10.1016/j.schres.2018.01.017.CrossRefPubMed

54.

Vila È, Huerta-Ramos E, Núñez C, Usall J, Ramos B. Specificity proteins 1 and 4 in peripheral blood mononuclear cells in postmenopausal women with schizophrenia: a 24-week double-blind, randomized, parallel, placebo-controlled trial. Eur Arch Psychiatry Clin Neurosci. 2019. https://doi.org/10.1007/s00406-018-0938-7.CrossRefPubMed

55.

Usall J, Huerta-Ramos E, Labad J, et al. Raloxifene as an adjunctive treatment for postmenopausal women with schizophrenia: a 24-week double-blind, randomized, parallel, placebo-controlled trial. Schizophr Bull. 2016;42(2):309–17. https://doi.org/10.1093/schbul/sbv149.CrossRefPubMed

56.

Pacello P, Baccaro LF, Pedro AO, Costa-Paiva L. Prevalence of hormone therapy, factors associated with its use, and knowledge about menopause: a population-based household survey. Menopause. 2018. https://doi.org/10.1097/GME.0000000000001066.CrossRefPubMed

57.

Lobo RA. Hormone-replacement therapy: current thinking. Nat Rev Endocrinol. 2017;13(4):220–31. https://doi.org/10.1038/nrendo.2016.164.CrossRefPubMed

58.

Kulkarni J, Riedel A, de Castella AR, et al. Estrogen - a potential treatment for schizophrenia. Schizophr Res. 2001. https://doi.org/10.1016/S0920-9964(00)00088-8.CrossRefPubMed

59.

Akhondzadeh S, Nejatisafa AA, Amini H, et al. Adjunctive estrogen treatment in women with chronic schizophrenia: a double-blind, randomized, and placebo-controlled trial. Prog Neuropsychopharmacol Biol Psychiatry. 2003;27(6):1007–12. https://doi.org/10.1016/S0278-5846(03)00161-1.CrossRefPubMed

60.

Kulkarni J, de Castella A, Fitzgerald PB, et al. Estrogen in severe mental illness: a potential new treatment approach. Arch Gen Psychiatry. 2008;65(8):955–60. https://doi.org/10.1001/ARCHPSYC.65.8.955.CrossRefPubMed

61.

Ghafari E, Fararouie M, Shirazi HG, Farhangfar A, Ghaderi F, Mohammadi A. Combination of estrogen and antipsychotics in the treatment of women with chronic schizophrenia: a double-blind, randomized, placebo-controlled clinical trial. Clin Schizophr Relat Psychoses. 2013;6(4):172–6. https://doi.org/10.3371/CSRP.GHFA.01062013.CrossRefPubMed

62.

Kulkarni J, Gavrilidis E, Wang W, et al. Estradiol for treatment-resistant schizophrenia: a large-scale randomized-controlled trial in women of child-bearing age. Mol Psychiatry. 2015;20(6):695–702. https://doi.org/10.1038/mp.2014.33.CrossRefPubMed

63.

Weiser M, Levi L, Zamora D, et al. Effect of adjunctive estradiol on schizophrenia among women of childbearing age: a randomized clinical trial. JAMA Psychiat. 2019. https://doi.org/10.1001/jamapsychiatry.2019.1842.CrossRef

64.

Kulkarni J, Gurvich C, Lee SJ, et al. Piloting the effective therapeutic dose of adjunctive selective estrogen receptor modulator treatment in postmenopausal women with schizophrenia. Psychoneuroendocrinology. 2010;35(8):1142–7. https://doi.org/10.1016/j.psyneuen.2010.01.014.CrossRefPubMed

65.

Usall J, Huerta-Ramos E, Iniesta R, et al. Raloxifene as an adjunctive treatment for postmenopausal women with schizophrenia: a double-blind, randomized, placebo-controlled trial. J Clin Psychiatry. 2011;72(11):1552–7. https://doi.org/10.4088/JCP.10m06610.CrossRefPubMed

66.

Kianimehr G, Fatehi F, Hashempoor S, et al. Raloxifene adjunctive therapy for postmenopausal women suffering from chronic schizophrenia: a randomized double-blind and placebo controlled trial. Daru. 2014;22:55. https://doi.org/10.1186/2008-2231-22-55.CrossRefPubMedPubMedCentral

67.

Weickert TW, Weinberg D, Lenroot R, et al. Adjunctive raloxifene treatment improves attention and memory in men and women with schizophrenia. Mol Psychiatry. 2015;20(6):685–94. https://doi.org/10.1038/mp.2015.11.CrossRefPubMedPubMedCentral

68.

Kulkarni J, Gavrilidis E, Gwini SM, et al. Effect of adjunctive raloxifene therapy on severity of refractory schizophrenia in women. JAMA Psychiat. 2016;73(9):947. https://doi.org/10.1001/jamapsychiatry.2016.1383.CrossRef

69.

Weiser M, Levi L, Burshtein S, et al. Raloxifene plus antipsychotics versus placebo plus antipsychotics in severely ill decompensated postmenopausal women with schizophrenia or schizoaffective disorder: a randomized controlled trial. J Clin Psychiatry. 2017;78(7):e758–65. https://doi.org/10.4088/JCP.15m10498.CrossRefPubMed

70.

• Zhang L, Qi H, Xie YY, et al. Efficacy and safety of adjunctive aripiprazole, metformin, and paeoniae-glycyrrhiza decoction for antipsychotic-induced hyperprolactinemia: a network meta-analysis of randomized controlled trials. Front Psychiatry. 2021;12. https://doi.org/10.3389/FPSYT.2021.728204. Network meta-analysis comparing the efficacy and safety of adjunctive therapies for correcting antipsychotic-induced elevated prolactin levels.

71.

Zhu C, Li R, Ju M, et al. Metformin in the treatment of amisulpride-induced hyperprolactinemia: a clinical Trial. Front Mol Neurosci. 2022. https://doi.org/10.3389/FNMOL.2022.892477.CrossRefPubMedPubMedCentral

72.

Scandlyn MJ, Stuart EC, Rosengren RJ. Sex-specific differences in CYP450 isoforms in humans. Expert Opin Drug Metab Toxicol. 2008;4(4):413–24. https://doi.org/10.1517/17425255.4.4.413.CrossRefPubMed

73.

Choi SY, Koh KH, Jeong H. Isoform-specific regulation of cytochromes P450 expression by estradiol and progesterone. Drug Metab Dispos. 2013;41(2):263–9. https://doi.org/10.1124/DMD.112.046276.CrossRefPubMedPubMedCentral

74.

Hiemke C, Bergemann N, Clement H, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry. 2018;51(01/02):9–62. https://doi.org/10.1055/s-0043-116492.CrossRefPubMed

75.

• Zucker I, Prendergast BJ. Sex differences in pharmacokinetics predict adverse drug reactions in women. Biol Sex Differ. 2020;11(1):32. https://doi.org/10.1186/s13293-020-00308-5. This article summarizes sex differences in pharmacokinetics of diverse types of medications and provides valuable insights on how these differences predict adverse drug reactions in women.CrossRefPubMedPubMedCentral

76.

Brand BA, de Boer JN, Dazzan P, Sommer IE. Towards better care for women with schizophrenia-spectrum disorders. Lancet Psychiatry. 2022;9(4):330–6. https://doi.org/10.1016/S2215-0366(21)00383-7.CrossRefPubMed

77.

• Schoretsanitis G, Kane JM, Correll CU, et al. Blood levels to optimize antipsychotic treatment in clinical practice: a joint consensus statement of the American Society of Clinical Psychopharmacology and the Therapeutic Drug Monitoring Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie. J Clin Psychiatry. 2020;81(3):3649. https://doi.org/10.4088/JCP.19CS13169. This consensus statement summarizes essential information on the routine use of TDM for antipsychotics which can be used to perform TDM as part of the clinical decision-making process.CrossRef

Title: Evidence-Based Recommendations for the Pharmacological Treatment of Women with Schizophrenia Spectrum Disorders
Authors: Bodyl A. Brand
Elske J. M. Willemse
Iris M. H. Hamers
Iris E. Sommer
Publication date: 21-10-2023
Publisher: Springer US
Keywords: Aripiprazole
Antipsychotics
Antipsychotics
Schizophrenia
Quetiapine
Olanzapine
Hyperprolactinemia
Amisulpride
Published in: Current Psychiatry Reports / Issue 11/2023
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI: https://doi.org/10.1007/s11920-023-01460-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evidence-Based Recommendations for the Pharmacological Treatment of Women with Schizophrenia Spectrum Disorders

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 11/2023

Insomnia During the Perinatal Period and its Association with Maternal and Infant Psychopathology: A Systematic Review and Meta-Analysis

Sadism and Personality Disorders

Gamification: a Novel Approach to Mental Health Promotion

Magnetic Resonance Spectroscopy Studies of Brain Energy Metabolism in Schizophrenia: Progression from Prodrome to Chronic Psychosis

Digital Tools in the Service of Peer and Social Support for Perinatal Mental Health

The Role of Peer Providers to Scale Up Psychological Treatments for Perinatal Populations Worldwide