Journal of Psychology & Psychotherapy
Open Access
ISSN: 2161-0487
+44 1478 350008
ISSN: 2161-0487
+44 1478 350008
Noah King1, Alicia Nahhas1, Jack Mariani1, Chandani Lewis1
1Department of Psychiatry, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
Scientific Tracks Abstracts: J Psychol Psychother
Background: Antipsychotics are a class of medications used to treat disorders such as psychosis, mood disorders, and agitation. Atypical antipsychotics have long been associated with the side effects of weight gain, diabetes, and metabolic syndrome. However, their relationship to Polycystic Ovarian Syndrome (PCOS) is unclear. PCOS is the most common endocrinological pathology affecting women of childbearing age worldwide (between 4 and 20% globally). Methodology: A literature search of Pubmed, Embase and Cochrane was conducted using the keywords PCOS, polycystic ovary syndrome, antipsychotic(s), dopamine antagonist(s). Findings: A case control study of 225 patients in Sri Lanka found women on atypical antipsychotics were more likely to have PCOS than controls (21.6% vs 8.1%, p=0.04). Furthermore, a retrospective cohort study in Taiwan found increased occurrence of PCOS in patients initiated on antipsychotics, particularly ziprasidone (105.2 per 1,000 person year) and haloperidol (51.7 per 1,000 person year). One study found women with bipolar disorder controlled by atypical antipsychotics reported a greater rate of current or past menstrual abnormalities versus those on mood stabilizer therapy (80% versus 55%, p = 0.013). On the contrary, several studies have suggested that high levels of DHEA and the steep declines in estrogen during infrequent ovulation causes vulnerability to psychosis. One study showed that women with PCOS had a three-fold increase in risk for psychosis by age 50, possibly indicating an increased need for antipsychotics in this population. Conclusion and Significance: The overlap of clinical presentation often makes it difficult to distinguish PCOS from adverse effects of antipsychotics. Hyperandrogenism and rapid changes in estrogen levels seen in PCOS can increase risk for psychosis and subsequent antipsychotic need. Appropriate discussion with reproductive age women regarding potential reproductive impacts of antipsychotic use is crucial to patient-centered care. Further study should prospectively monitor PCOS development with antipsychotic therapy.
Noah King is a MD candidate for the Class of 2025 at The University of Toledo College of Medicine. He is applying into psychiatry residency training and wishes to practice psychiatry in the United States. He is compassionate about patient-centered treatment of psychiatric disease and research on improving psychiatric care.