Data on the specific effects of sex on pharmacokinetics, as well as tolerability, safety, and efficacy of psychotropic medications are still meager, mainly because only recently sex-related issues have attracted a certain degree of interest within the pharmacological domain. Therefore, with the present study, we aimed to provide a comprehensive review of the literature on this topic, through careful MEDLINE and PubMed searches of the years 1990-2012. Generally, data on pharmacokinetics are more consistent and numerous than those on pharmacodynamics. Sex-related differences have been reported for several parameters that influence pharmacokinetics, such as gastric acidity, intestinal motility, body weight and composition, blood volume, liver enzymes (mainly the cytochrome P450), or renal excretion, which may alter plasma drug levels. Sex-related peculiarities may also account for a different sensitivity of men and women to side effects and toxicity of psychotropic drugs. Further, some differences in drug response, mainly to antipsychotics and antidepressants, have been described. Further studies are, however, necessary to explore more thoroughly the impact of sex on the pharmacokinetics and pharmacodynamics of psychotropic drugs, in order to reach the most appropriate and tailored prescription for each patient.

Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by the presence of obsessions and/or compulsions, which has been commonly associated with alterations of some neurotransmitters systems, in particular, the serotonin and dopamine ones. However, it is now evident that these supposed disturbances cannot explain the development of this disorder, and so other possible mechanisms have been invoked, such as those involving the immune system that is attracting an increasing interest. According to the current literature, immune system alterations are reported in OCD of both children and adults. In children, it has been widely described as a clinical syndrome resulting from infections driven by group A β-hemolytic streptococci and characterized by rheumatic fever, OCD, and neurological symptoms called "pediatric autoimmune neuropsychiatric disorders associated with streptococcus". In adults, available findings are meager and controversial, although intriguing. Such preliminary findings underline the presence of OCD in a number of autoimmune disorders, as well as of alterations of different immune parameters in OCD patients. This paper aims at presenting an exhaustive review of the role of the immune system in the development of OCD, with a major focus on the possible pathophysiological role of cytokines that seems to open novel treatment options.

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