Antidepressants’ effects on testosterone and estrogens: What do we know?

Pavlidi, Pavlina; Kokras, Nikolaos; Dalla, Christina

doi:10.1016/j.ejphar.2021.173998

Cited by 41 publications

(24 citation statements)

References 103 publications

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“…Notwithstanding, pharmacotherapeutic-induced hyper-prolactin reflects a cryptorrhea phenomenon, the effects of which should be elucidated in a prospective cohort study. Psychiatric medications have secondary effects on the hemic system ( Dahl, 1986 ; Krieger et al, 2004 ; Dietrich-Muszalska and Wachowicz, 2017 ; Pavlidi et al, 2021 ), and thus can cause or exacerbate coagulation disorders and abnormal bleeding, which can lead to HMB in women ( Yasui-Furukori et al, 2012 ; Kranz et al, 2021 ). Although the precise mechanisms underlying these drug effects are unknown, physicians should be screening for HMB in the course of female psychiatric patient monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…In mentally ill women, HMB has been reported to be associated with further psychiatric deterioration ( Iles and Gath, 1989 ; Shannon, 1993 ; Pramodh, 2020 ; Arias-de la Torre et al, 2021 ; Padda et al, 2021 ). HMB in overweight women specifically has been related to metabolic disorders of blood glucose, lipids, and reproductive hormones ( Iles and Gath, 1989 ; Shannon, 1993 ; Noerpramana, 1997 ; Pottegård et al, 2018 ; Pramodh, 2020 ; Schlaff et al, 2020 ; Arias-de la Torre et al, 2021 ; Padda et al, 2021 ; Pavlidi et al, 2021 ), all of which can be induced or exacerbated by psychiatric drugs ( Iles and Gath, 1989 ; APA, 1994 ; Noerpramana, 1997 ; Meyer, 2002 ; Reynolds et al, 2007 ; Muir et al, 2008 ; Bradley and Gueye, 2016 ; Bora et al, 2017 ; Culpepper et al, 2017 ; Solé et al, 2017 ; Bekhbat et al, 2018 ; Pottegård et al, 2018 ; Calaf et al, 2020 ; Pramodh, 2020 ; Schlaff et al, 2020 ; Jang et al, 2021 ; Padda et al, 2021 ; Pavlidi et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, HMB can impair cognitive ability ( Iles and Gath, 1989 ; Shannon, 1993 ; APA, 1994 ; Noerpramana, 1997 ; Meyer, 2002 ; Reynolds et al, 2007 ; Muir et al, 2008 ; El-Nashar et al, 2010 ; Bradley and Gueye, 2016 ; Bora et al, 2017 ; Culpepper et al, 2017 ; Solé et al, 2017 ; Bekhbat et al, 2018 ; Pottegård et al, 2018 ; Calaf et al, 2020 ; Pramodh, 2020 ; Schlaff et al, 2020 ; Arias-de la Torre et al, 2021 ; Jang et al, 2021 ; Padda et al, 2021 ; Pavlidi et al, 2021 ; Stahl, 2021 ), which may also be directly affected by mental illness and mental illness treatments ( Iles and Gath, 1989 ; Shannon, 1993 ; APA, 1994 ; First et al, 1996 ; Noerpramana, 1997 ; Meyer, 2002 ; Reynolds et al, 2007 ; Muir et al, 2008 ; El-Nashar et al, 2010 ; Bradley and Gueye, 2016 ; Bora et al, 2017 ; Culpepper et al, 2017 ; Solé et al, 2017 ; Bekhbat et al, 2018 ; Pottegård et al, 2018 ; Calaf et al, 2020 ; Pramodh, 2020 ; Schlaff et al, 2020 ; Arias-de la Torre et al, 2021 ; Jang et al, 2021 ; Padda et al, 2021 ; Pavlidi et al, 2021 ; Stahl, 2021 ). Additionally, HMB may compromise patients’ reproductive potential ( Iles and Gath, 1989 ; Shannon, 1993 ; APA, 1994 ; First et al, 1996 ; Noerpramana, 1997 ; Meyer, 2002 ; Reynolds et al, 2007 ; Muir et al, 2008 ; Bradley and Gueye, 2016 ; Bora et al, 2017 ; Culpepper et al, 2017 ; Solé et al, 2017 ; ...…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders

et al. 2022

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There has been limited studies examining treatment-induced heavy menstrual bleeding (HMB) in women with severe mental illnesses. The aim of this study was to examine HMB prevalence and HMB-associated factors in young women (18–34 years old) diagnosed with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia (SCZ) who have full insight and normal intelligence. Eighteen-month menstruation histories were recorded with pictorial blood loss assessment chart assessments of HMB. Multivariate analyses were conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Drug effects on cognition were assessed with the MATRICS Consensus Cognitive Battery (MCCB). HMB prevalence were: BP, 25.85%; MDD, 18.78%; and SCH, 13.7%. High glycosylated hemoglobin (HbA1c) level was a strong risk factor for HMB [BP OR, 19.39 (16.60–23.01); MDD OR, 2.69 (4.59–13.78); and SCZ OR, 9.59 (6.14–12.43)]. Additional risk factors included fasting blood sugar, 2-h postprandial blood glucose, and use of the medication valproate [BP: OR, 16.00 (95%CI 12.74–20.22); MDD: OR, 13.88 (95%CI 11.24–17.03); and SCZ OR, 11.35 (95%CI 8.84–19.20)]. Antipsychotic, antidepressant, and electroconvulsive therapy use were minor risk factors. Pharmacotherapy-induced visual learning impairment was associated with HMB [BP: OR, 9.01 (95%CI 3.15–13.44); MDD: OR, 5.99 (95%CI 3.11–9.00); and SCZ: OR, 7.09 (95%CI 2.99–9.20)]. Lithium emerged as a protective factor against HMB [BP: OR, 0.22 (95%CI 0.14–0.40); MDD: OR, 0.30 (95%CI 0.20–0.62); and SCZ: OR, 0.65 (95%CI 0.33–0.90)]. In SCZ patients, hyperlipidemia and high total cholesterol were HMB-associated factors (ORs, 1.87–2.22). Psychiatrist awareness of HMB risk is concerningly low (12/257, 2.28%). In conclusion, prescription of VPA should be cautioned for women with mental illness, especially BP, and lithium may be protective against HMB.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders

et al. 2022

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“…As several drugs interact with TRT, we recommend checking for possible drug interactions before starting TRT. As use of psychotropic and anti-epileptic drugs is common in adults with PWS, it is especially important to check for interactions with drugs like selective serotonin reuptake inhibitors, anti-epileptic medication and psychostimulants like modafinil [ 58 , 59 , 60 , 61 , 62 , 63 ]. As these drugs may influence serum testosterone concentrations, adjustment of the dose of TRT might be needed.…”

Section: Discussionmentioning

confidence: 99%

Hypogonadism in Adult Males with Prader-Willi Syndrome—Clinical Recommendations Based on a Dutch Cohort Study, Review of the Literature and an International Expert Panel Discussion

Pellikaan

Brahim

Rosenberg

et al. 2021

JCM

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Prader–Willi syndrome (PWS) is a complex genetic syndrome characterized by hyperphagia, intellectual disability, hypotonia and hypothalamic dysfunction. Adults with PWS often have hormone deficiencies, hypogonadism being the most common. Untreated male hypogonadism can aggravate PWS-related health issues including muscle weakness, obesity, osteoporosis, and fatigue. Therefore, timely diagnosis and treatment of male hypogonadism is important. In this article, we share our experience with hypogonadism and its treatment in adult males with PWS and present a review of the literature. In order to report the prevalence and type of hypogonadism, treatment regimen and behavioral issues, we retrospectively collected data on medical interviews, physical examinations, biochemical measurements and testosterone replacement therapy (TRT) in 57 Dutch men with PWS. Fifty-six (98%) of the patients had either primary, central or combined hypogonadism. Untreated hypogonadism was associated with higher body mass index and lower hemoglobin concentrations. TRT was complicated by behavioral challenges in one third of the patients. Undertreatment was common and normal serum testosterone levels were achieved in only 30% of the patients. Based on the Dutch cohort data, review of the literature and an international expert panel discussion, we provide a practical algorithm for TRT in adult males with PWS in order to prevent undertreatment and related adverse health outcomes.

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Joint effect of testosterone and neurofilament light chain on cognitive decline in men: The Shanghai Aging Study

Tang,

Xiao,

Lin

et al. 2024

Alzheimer's & Dementia

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INTRODUCTIONThe association of testosterone and cognitive decline is inconclusive, and its joint effect with neurofilaments light chain (NfL) remains largely unknown.METHODSA total of 581 non‐demented older men in the Shanghai Aging Study were included. Blood total testosterone (TT), free testosterone (FT), and NfL were measured at baseline. The relationships between TT, FT, TT/FT‐NfL, and cognitive decline were explored by Cox regression models.RESULTSDuring a median follow‐up of 6.7 years, there was an inverse association between TT/FT and cognitive decline (TT, trend p = .004, Q1 vs Q4, hazard ratio [HR] = 4.39, 95% confidence interval [CI] = 1.60 to 12.04; FT, trend p = .002, Q1 vs Q4, HR = 5.29, 95% CI = 1.50 to 16.89). Compared to participants with high TT/FT‐low NfL, those with low TT/FT‐high NfL had significantly higher risks of cognitive decline (TT, HR = 5.10, 95% CI = 1.11 to 23.40; FT, HR = 6.14, 95% CI = 1.34 to 28.06).DISCUSSIONOur findings suggest that the combination of testosterone and neurodegenerative markers may provide reliable predictive insights into future cognitive decline.Highlights Testosterone is inversely associated with cognitive decline in older men. There is a joint effect of testosterone and NfL on cognitive decline. Sex hormone and neurodegeneration may synergistically contribute to cognitive deterioration.

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Antidepressants’ effects on testosterone and estrogens: What do we know?

Cited by 41 publications

References 103 publications

Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders

Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders

Hypogonadism in Adult Males with Prader-Willi Syndrome—Clinical Recommendations Based on a Dutch Cohort Study, Review of the Literature and an International Expert Panel Discussion

Joint effect of testosterone and neurofilament light chain on cognitive decline in men: The Shanghai Aging Study

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