Past Issues

Background: Perimenopausal women may have an increased vulnerability to
psychosis. Antipsychotic drugs are considered effective for acute and maintenance
treatment of menopausal psychosis. In those patients who respond poorly to antipsychotic
agents, estrogen augmentation may be also benefi cial. Case report: We
present a 50-year-old woman experiencing psychotic symptoms with onset one
year after the menopause. The patient with positive psychotic symptoms did not
respond well to three different antipsychotic drugs at adequate dosage and duration.
But she responded with a combination of antipsychotic drug and Premelle 2.5
(conjugated estrogen 0.625 + medroxyprogesterone 2.5mg) daily, and achieved a
satisfactory treatment response. The patient’s psychotic symptoms were re-emerged
after discontinuation of Premelle and were resolved after resuming Premelle treatment.
Conclusion: Estrogen modulates the dopamine system in a mechanism similar
to neuroleptic drugs and is an effective augmentation treatment for menopausal
psychosis.