Several years ago, we reviewed a paper suggesting that estrogen may be a beneficial treatment for women with schizophrenia.  In this study, patients with schizophrenia were treated with estrogen.  There was significant improvement in their positive symptoms (hallucinations, delusions), but no difference in negative symptoms (reduction in range of emotional expression, poverty of speech, lack of motivation).

A new study looks at the effects of raloxifene, a selective estrogen receptor modulator (SERM).  Raloxifene (marketed as Evista) is a first-generation SERM that is used currently as a preventive treatment for postmenopausal osteoporosis.  Similar to conjugated estrogens, raloxifene modulates various neurotransmitter symptoms involved in the pathogenesis of schizophrenia.  The present study looks at the effects of adjunctive raloxifene treatment on cognition and symptom severity in young to middle-aged men and women with schizophrenia.

98 patients with a diagnosis of schizophrenia or schizoaffective disorder were recruited into randomized, double-blind, placebo-controlled trial of raloxifene added to the patients’ standard antipsychotic medications. Symptom severity and cognition in the domains of working memory, attention/processing speed, language and verbal memory were assessed at baseline, 6 and 13 weeks.

Participants receiving adjunctive raloxifene treatment showed significant improvement compared to placebo in memory and attention/processing speed. There was no reduction in symptom severity with treatment compared with placebo.  There was also indication that some cognitive benefits were sustained even after raloxifene was discontinued.

While this study did not show any beneficial effects of raloxifene in terms of symptom severity, raloxifene may be a useful adjunctive treatment for both men and women suffering from the cognitive deficits associated with schizophrenia.

Ruta Nonacs, MD PhD

Weickert TW, Weinberg D, Lenroot R, et al.  Adjunctive raloxifene treatment improves attention and memory in men and women with schizophrenia.  Mol Psychiatry. 2015 Jun;20(6):685-94.