Schizophrenia Clinical Trial
Official title:
A Randomized Trial Administering Estradiol Patch vs. Placebo Patch as add-on to Antipsychotics in Female Patients Above the Age of 38 With Schizophrenia, Schizoaffective or Schizophreniform Disorder
The objective of the study is to evaluate the efficacy of Estradiol patch compared to placebo, as add-on to anti-psychotics in the treatment of women 38 and older with schizophrenia, schizoaffective or schizophreniform disorder.
Several lines of evidence suggest that estrogen affects the course of schizophrenia. The
onset of schizophrenia is 2-4 years later in women than in men, and women have a lower
incidence of schizophrenia until menopause, after which women have an increased incidence, so
that the lifetime prevalence is similar in both genders. Women are more likely to have their
first schizophrenic episode during an estradiol trough in the menstrual cycle. These gender
differences in the natural course of schizophrenia are well replicated and provide a major
lead to understanding and treating the illness, and have led to several randomized controlled
trials administering oral estradiol to patients with schizophrenia. Studies on transdermal
estradiol have been more encouraging, and four RCTs, have shown that estradiol patches are
efficacious in treating schizophrenia The most recent study was performed our group and
showed that overall estradiol patches were efficacious with an effect size of 0.41 for total
PANSS, with significant improvements in PANSS positive, negative and general-psychopathology
scores. Post hoc analyses showed that the improvements in symptoms were found almost
exclusively in women who were 38 and older, in whom the effect of estrogen patches vs placebo
reached an effect size of 0.58 for PANSS total.
The currently proposed study is based on the post-hoc finding of improvement in participants
aged 38 and above, and we will a-priori recruit women with schizophrenia 38 and above, in
order to test the efficacy of 200 µg estradiol patches vs placebo in these woman.
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