Hormonal changes

What are hormones?

Hormones are chemical messengers secreted by the endocrine glands. Hormones travel through the bloodstream to tissues and organs, and control most of the body’s major systems including heart rate, metabolism, mood, sexual function, and growth and development.

The hormone oestrogen has been proposed to confer a protective effect for schizophrenia. Women generally have a later onset of schizophrenia than males, with an increased risk after menopause (see the risk factor topic on sex differences). Oestrogen levels drop over time, particularly with the onset of menopause. This protection may also mean that pre-menopausal women who develop schizophrenia may experience a less severe illness than males.

Prolactin is another hormone implicated in schizophrenia. It is a polypeptide secreted by the pituitary gland. It is involved in many biological functions such as reproduction, pregnancy and lactation, and growth and development. Some medications, including antipsychotics are among the factors that can affect blood prolactin concentrations. Increased prolactin is associated with a variety of adverse effects, including risk of breast cancer, lack of menstruation, and early osteoporosis in women, and a lack of libido and erectile function in men.

What is the evidence for hormonal changes in people with schizophrenia?

Moderate to high quality evidence finds a small to medium increase in leptin levels, particularly in patients taking second generation antipsychotics olanzapine and clozapine. There may also be reduced adiponectin levels in patients taking clozapine or olanzapine.

Moderate quality evidence found a large increase in prolactin levels in antipsychotic-naïve males with schizophrenia and a medium-sized increase in antipsychotic-naïve females with schizophrenia. There was also a medium to large increase in dehydroepiandrosterone-sulfate levels, with testosterone elevated only in first-episode psychosis patients and in patients during an acute relapse.

December 2019

Last updated at: 6:30 am, 3rd December 2019
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