Extrapyramidal symptoms and oestrogen

Objective: The present study aimed to investigate neuroleptic side-effect severity in women with psychosis, and to investigate their putative association with variations in sex steroids over the menstrual cycle. Based on the oestrogen hypothesis. which postulates a synergistic relationship between oestrogen and neuroleptics, it was hypothesized that oestrogen would exacerbate extrapyramidal symptoms. Method: Twenty-five psychotic women were assessed using the ESRS and blood hormone analysis. Testing was conducted twice, 2 weeks apart, in a randomized cross-over design. Results: Contrary to expectation the results indicated that high levels of oestrogen reduce hyperkinetic symptoms in women with psychosis, and this effect appears to be further potentiated when both oestrogen and progesterone are high. Conclusion: On the basis of these findings, and receptor studies in animals, it was concluded that oestrogen has different effects on dopamine dynamics in the mesolimbic and mesostriatal pathways.