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Review
. 2020 May;33(3):192-199.
doi: 10.1097/YCO.0000000000000597.

Do we need sex-oriented clinical practice guidelines for the treatment of schizophrenia?

Piyumi Fernando  1 , Iris E C Sommer  2 , Alkomiet Hasan  1   3
Affiliations
Review

Do we need sex-oriented clinical practice guidelines for the treatment of schizophrenia?

Piyumi Fernando et al. Curr Opin Psychiatry. 2020 May.

Abstract

Purpose of review: Clinical practice guidelines (CPGs) do not usually offer a sex-specific approach for the management of schizophrenia. With this narrative review, we aim to give an integrated and synthesized overview of the current state of knowledge regarding sex-specific aspects in schizophrenia and how this topic may be adapted in the development of CPGs.

Recent findings: Recent studies further suggest sex-specific differences in epidemiologic features, the course of illness, underlying pathomechanisms, response likelihood to antipsychotic medication and differences in tolerability. Beyond this, selective estrogen receptor modulators like raloxifene have shown beneficial effects on symptom severity and cognition in women with schizophrenia.

Summary: Sex-specific aspects can already be integrated in clinical guideline recommendations, especially with regard to efficacy and tolerability of antipsychotic treatment. Moreover, these aspects may be used for an individual risk-stratification. Recent studies provide evidence supporting the hypothesis of sex-specific modulation in schizophrenia and build the groundwork for sex-specific novel treatment options. However, there remains a clear need for additional studies focusing on women with schizophrenia to substantiate current findings.

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References

    1. GBD 2017 HIV collaboratorsGlobal, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Lancet HIV 2019; 6:e831–e859.
    1. Aleman A, Kahn RS, Selten JP. Sex differences in the risk of schizophrenia: evidence from meta-analysis. Arch Gen Psychiatry 2003; 60:565–571.
    1. Searles S, Makarewicz JA, Dumas JA. The role of estradiol in schizophrenia diagnosis and symptoms in postmenopausal women. Schizophrenia Res 2018; 196:35–38.
    1. Excellence NIfHaC. Psychosis and schizophrenia: treatment and management. Clinical guideline 178 2014.
    1. Kreyenbuhl J, Buchanan RW, Dickerson FB, et al. Schizophrenia Patient Outcomes Research Team (PORT)The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009. Schizophr Bull 2010; 36:94–103.

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