Sex differences in side effects of second-generation antipsychotics

Abstract

Results It is known that pharmacokinetics differ between females and males, with a higher activity in females for CYP3A4 and CYP2D6. Yet, significantly higher plasma levels in women have only been demonstrated for olanzapine and clozapine. Regarding side effects, although not well studied, some of them such as hyperprolactinaemia, weight gain and cardiac effects are reported to affect more often women. There is -although controversialevidence for more pronounced prolactin levels in females. There are also some published studies that indicate that metabolic syndrome (visceral adiposity, hyperglycaemia, hypertension and dyslipidaemia) induced by SGAs is more frequent in females. Lastly, the risk of QT prolongation is again higher in females. There is no evidence for sex differences in SGAs causing extrapyramidal symptoms, acute dystonia or any other movement disturbance. Conclusions In conclusion, there is some evidence of sex differences in side effects of the SGAs. However, data are obtained by posthoc analysis, not to mention that clinical trials of new therapeutic drugs have been conducted, for the most part, with male participants. Future studies with a primary focus on sex differences are required and will help to determine how these differences should influence clinical management. from International Society on Brain and Behaviour: 3rd International Congress on Brain and Behaviour Thessaloniki, Greece. 28 November – 2 December 2007