Relationship of gender and menstrual status to symptoms and medication side effects in patients with schizophrenia

Abstract

Schizophrenic outpatients (62 females, 59 males) were evaluated to examine the relationships between menstrual status, gender, clinical measures of psychopathology and drug side effects. Menstrual status was determined for 55 female patients. Blood from 44 female subjects, drawn before the AM dose of neuroleptic, was assayed for prolactin concentrations. In 27 premenopausal women (age<45 years), six (22%) reported irregular menses and one (4%) reported amenorrhea. Women with irregular menses did not differ in their prolactin levels or neuroleptic dose, from women with regular menses. Amenorrheic women (n=22) were significantly older than men (n=59) and menstruating women (n=33). After controlling for age, menstruating women did not differ in clinical measures of psychopathology, drug side effects, or neuroleptic dose compared to amenorrheic women or men. Comparison of 15 age-matched pairs of menstruating females and amenorrheic females revealed significantly lower levels of akathisia and depression in the menstruating group and a trend towards lower serum prolactin concentrations (P=0.08). In female subjects, prolactin levels correlated significantly with neuroleptic dose (r=0.36, P<0.005). Our results only partially support hypothesized relationships between menstrual status, prolactin levels and neuroleptic effects and serve to emphasize the importance of controlling for age when comparing these clinical variables.