Estrogens regulate clinical symptoms through their influence on with dopamine pathways, as well as by regulating mitochondrial functioning and the stress response system. Estrogen deficiency is common in schizophrenia and is often related to hyperprolactinemia in both medication-naïve and chronic patients.
Schizophrenia and Progesterone
Based on the clinical studies available there appears to be a link between lower symptom scores and the mid-luteal phase of the menstrual cycle, which is associated with high progesterone/high estradiol levels” (24).
Recently, it was reported that baseline levels of progesterone were significantly higher in first-episode antipsychotic-naïve patients with schizophrenia than in normal controls. It was speculated that lower levels of progesterone at baseline may predict better therapeutic outcome of antipsychotic treatment (26).
Many epidemiological studies have highlighted the link between vitamin D deficiency and schizophrenia. In particular, two prominent studies report an association between neonatal vitamin D deficiency and an increased risk of schizophrenia.
A large review of over 800 patients found that people who took high-dose B-vitamins like B6, B8, and B12 in addition to their medications significantly reduced symptoms of schizophrenia, compared with those who took medicines alone. These supplements seem most helpful when people start them early in their illness.
Vitamin D supplementation in patients with schizophrenia
One study showed that vitamin D supplementation (50,000 IU vitamin D/week for 12 weeks) improved positive and negative syndrome scale scores and metabolic profiles including reduction in fasting plasma glucose, and cholesterol levels [45].
The brain releases dopamine in response to pleasure and rewards. Abnormalities in the brain's dopamine system are linked to the development of schizophrenia symptoms.
When estrogen levels are low, women are more susceptible and respond poorly to anti-psychotic drugs. Consequently, estrogen is often used to treat schizophrenia in women. Studies show that estrogen patches can reduce the positive symptoms of schizophrenia (at least in the short term).
Now, a United States-based biotech organisation called Karuna Therapeutics Inc. has developed a new combination drug called KarXT. It is the first potential new pharmacological approach for treating schizophrenia in over 50 years and may provide an alternative option for people living with the condition.
Clozapine is the most effective antipsychotic in terms of managing treatment-resistant schizophrenia. This drug is approximately 30% effective in controlling schizophrenic episodes in treatment-resistant patients, compared with a 4% efficacy rate with the combination of chlorpromazine and benztropine.
The main type of talking therapy recommended for the treatment of schizophrenia is cognitive behavioural therapy (CBT), which helps you identify and change any negative thoughts or behaviour that is making your life hard. CBT aims to help you: cope with symptoms of psychosis such as delusions or hearing voices.
Compared with healthy subjects, schizophrenic patients may also have increased levels of serotonin and decreased levels of norepinephrine in the brain.
Schizophrenia is associated with changes in the structure and functioning of a number of key brain systems, including prefrontal and medial temporal lobe regions involved in working memory and declarative memory, respectively.
Researchers believe dopamine plays an important role in psychosis. Dopamine is a neurotransmitter, 1 of many chemicals the brain uses to transmit information from 1 brain cell to another.
The most common theory about the cause of schizophrenia is that there are too many dopamine receptors in certain parts of the brain, specifically the mesolimbic pathway. 1 This causes an increase in mesolimbic activity which results in delusions, hallucinations, and other psychotic symptoms.
Problems with anger, low self-esteem, anxiety, forgetfulness, impulsiveness and lack of organizational skill (symptoms of attention deficit hyperactivity disorder). Social withdrawal, reduced emotions, don't feel pleasure (negative symptoms of schizophrenia). Gastrointestinal symptoms, including chronic constipation.
In addition, patients with schizophrenia have lower erythrocyte magnesium levels than controls. Magnesium plays a major role in calming the nervous system due to it's ability to block brain N-methyl D-aspartate receptors (NMDA), thereby inhibiting excitatory neurotransmission.
Quetiapine tablets and extended-release (long-acting) tablets are used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions).
But a new drug is bringing hope to the field. Xanomeline-trospium, or KarXT, has a novel way of diminishing dopamine transmission that's showing promise at reducing symptoms while also limiting side effects.