Efecto del raloxifeno (Modulador Selectivo del Receptor Estrogénico (SERM)) como coadyuvante del tratamiento antidepresivo. A propósito de un caso / Effect of raloxifene (a Selective Estrogen Receptor Modulator [SERM]) as coadjuvant to antidepressant treatment: A case report

Se presenta el caso de una paciente con un trastorno depresivo con respuesta parcial al tratamiento antidepresivo. A la paciente se le añadió raloxifeno, Modulador Selectivo del Receptor Estrogénico (SERM), y se consiguió una remisión completa del episodio depresivo que presentaba. El interés de nuestro caso radica en el hecho que ejemplifica la relación entre los trastornos depresivos y los cambios hormonales durante la menopausia. Además, el raloxifeno puede ser una nueva opción terapéutica en algunas mujeres en la postmenopausia que no responden o lo hacen de forma parcial a los ISRS, especialmente en aquellas con historia de trastornos depresivos relacionados con la menopausia (AU)

We report a case of a woman with a depressive disorder with partial response to antidepressant treatment. Raloxifene, a Selective Estrogen Receptor Modulator (SERM) was added to the treatment, the patient achieving complete remission of her depressive symptoms. The interest of our case lies in the fact that it exemplifies the relationship between depressive disorders and hormonal changes during menopause. Furthermore, raloxifene may become a novel therapeutic option in some postmenopausal women who do not respond or only partially respond to SSRIs, especially in those with a history of depressive disorders related to menopause (AU)

Raloxifene as an adjunctive treatment for postmenopausal women with schizophrenia: a double-blind, randomized, placebo-controlled trial.

OBJECTIVE: The potential therapeutic utility of estrogens in schizophrenia is increasingly being recognized. Raloxifene, a selective estrogen receptor modulator, appears to act similarly to conjugated estrogens on dopamine and serotonin brain systems and may be a better option since it lacks the possible negative effects of estrogen on breast and uterine tissue. In this study, we assess the utility of raloxifene as an adjunctive treatment for negative symptoms and other psychotic symptoms in postmenopausal women with schizophrenia. METHOD: This was a 12-week, double-blind, randomized, placebo-controlled study. Patients were recruited from both the inpatient and outpatient departments of Parc Sanitari Sant Joan de Déu, Barcelona, Spain, and Corporació Sanitària Parc Taulí, Sabadell, Spain. Thirty-three postmenopausal women with schizophrenia (DSM-IV criteria) who exhibited prominent negative symptoms were randomized to either adjunctive raloxifene (16 women; mean age = 60.14 years, SD = 6.41 years) or adjunctive placebo (17 women; mean age = 62.66 years, SD = 4.54 years) for 12 weeks. The period of recruitment lasted from January 2005 through June 2009. Psychopathological symptoms were assessed at baseline and weeks 4, 8, and 12 by means of the Positive and Negative Syndrome Scale. RESULTS: The addition of raloxifene (60 mg/d) to regular antipsychotic treatment significantly reduced negative (P = .044), positive (P = .031), and general psychopathological (P = .045) symptoms during the 12-week trial as compared with women receiving placebo. CONCLUSIONS: Raloxifene as an adjuvant treatment in postmenopausal women with schizophrenia who exhibit prominent negative symptoms appears to be useful in improving negative, positive, and general psychopathological symptoms. If more extensive and longer-term studies confirm and expand upon these positive results, the use of raloxifene could be recommended in postmenopausal patients with schizophrenia. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01041092.

Effect of raloxifene (a Selective Estrogen Receptor Modulator (SERM)) as coadjuvant to antidepressant treatment: a case report.

We report a case of a woman with a depressive disorder with partial response to antidepressant treatment. Raloxifene, a Selective Estrogen Receptor Modulator (SERM) was added to the treatment, the patient achieving complete remission of her depressive symptoms. The interest of our case lies in the fact that it exemplifies the relationship between depressive disorders and hormonal changes during menopause. Furthermore, raloxifene may become a novel therapeutic option in some postmenopausal women who do not respond or only partially respond to SSRIs, especially in those with a history of depressive disorders related to menopause.

Social functioning in schizophrenia: what is the influence of gender?

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Background and Objectives: To examine the influence of gender on social functioning in patients with schizophrenia Methods: A sample of 318 schizophrenic (216 men and 102 women) (DSM-IV criteria) outpatients from four Spanish centers were administered the following instruments: Positive and Negative Symptom Scale (PANSS), Disability Assessment Scale (DAS-sv), and Global Assessment of Functioning (GAF) Scale. A regression model was created with DAS and GAF as dependent variables, and gender, and other predictor variables as independent variables. Separate regression models were then generated for females and males. Results: Women had a better social functioning than men, and after adjusting for others predictor variables gender was a significant predictor specially for occupational functioning. In gender specific analyses, we found that the predictive variables for social functioning have more similarities than differences between men and women. Conclusions: In our sample, women showed a better social functioning than men specially in occupational functioning (AU)

Influencia de la menopausia y el sexo en el funcionamiento neuropsicológico de pacientes con esquizofrenia / Influence of menopause and gender on neuropsychological functioning in outpatients with schizophrenia

Introducción: Se pretende establecer si las mujeres con esquizofrenia en la posmenopausia presentan más déficit en funciones cognitivas que mujeres en la premenopausia y varones con esquizofrenia. Material y método: Se ha evaluado a 125 pacientes que cumplen criterios del DSM-IV para el diagnóstico de esquizofrenia. Se les ha administrado un cuestionario sociodemográfico y una batería neuropsicológica que incluía: CPT-II, subtest de dígitos del WAIS-III, Trail Making Test A y B, Stroop Test, TAVEC y FAS. Resultados: Se encontraron diferencias estadísticamente significativas en memoria verbal y fluencia verbal, donde las mujeres con esquizofrenia en la posmenopausia obtuvieron mejores resultados que los varones (p < 0,05). En inatención e impulsividad, las mujeres en la posmenopausia obtuvieron peores resultados que los varones (p < 0,5). En algunas pruebas no se encuentran diferencias entre grupos. Conclusiones: Los resultados obtenidos en este estudio apoyan los resultados de investigaciones previas sobre la existencia de diferencias entre varones y mujeres con esquizofrenia en algunos aspectos de las funciones cognitivas. Nuestros resultados indican que las mujeres con esquizofrenia en la posmenopausia presentan un peor funcionamiento en atención y mejor en memoria, mientras que en otros aspectos cognitivos parecen no existir diferencias. Estos resultados parecen no apoyar la hipótesis inicial de que las mujeres en la posmenopausia obtendrían peores resultados en funciones cognitivas a causa de la disminución de los estrógenos que se produce en la posmenopausia

Introduction: The aim of this study was to assess whether menopausal women with schizophrenia show more neuropsychological deficits than premenopausal women and men with schizophrenia. Material and method: We assessed 125 patients fulfilling the DSM-IV criteria for schizophrenia. The patients were administered a sociodemographic questionnaire and a battery of neuropsychological tests including the continuous performance test (CPT-II), the Wechsler Adult Intelligence Scale (WAIS-III) digit subtest, the Trail Making Test parts A and B, the Stroop Test, the Complutense Verbal Learning test (TAVEC) and the Controlled Oral Word Association Test (FAS). Results: Postmenopausal women scored significantly better than men in verbal memory and verbal fluency tasks (P<.05) and significantly worse in inattention and impulsivity (P<.05). No significant differences among the groups were found in some of the tests. Conclusions: The results of this study support those of previous studies showing differences between men and women with schizophrenia in some cognitive functions. Our results suggest that postmenopausal women with schizophrenia show worse cognitive functioning in attention domains and better functioning in memory domains, while other neuropsychological domains seem to show no gender differences. These results do not support the initial hypothesis that postmenopausal women would show worse cognitive functioning due to the reduction of estrogens after menopause (AU)