Women, Aging, and Alcohol Use Disorders

During the postpartum and menopausal periods of women’s lives, there is a well-established and significant drop of circulating estrogens. This may be the reason why both these periods are associated with an increased risk for onset or exacerbation of psychiatric disorders. Whether symptoms are mainly affective or mainly psychotic, these disorders are frequently treated with antipsychotic medications, which calls for an examination of the relationship between hormone replacement and antipsychotic agents at these time periods. The aim of this narrative review is to summarize what is known about the association of hormones and antipsychotics in the postnatal period and at menopause. In the review, we focus on estrogen and oxytocin hormones and include, for the most part, only papers published within the last 10 years. Both estradiol and oxytocin have at various times been implicated in the etiology of postpartum disorders, and estrogens, sometimes combined with progesterone, have been tested as potential treatments for these conditions. The role of estradiol as an adjunct to antipsychotics in the prevention of postpartum relapses is currently controversial. With respect to oxytocin, studies are lacking. Psychosis in menopausal and postmenopausal women has been successfully treated with estrogens and selective estrogen-receptor modulators, mainly raloxifene, in addition to antipsychotics. Some symptoms appear to respond better than others. No oxytocin study has specifically targeted postmenopausal women. Because of feedback mechanisms, there is a theoretical danger of therapy with exogenous hormones interfering with endogenous secretion and disturbing the balance among inter-related hormones. When used with antipsychotics, hormones may also affect the metabolism and, hence, the brain level of specific antipsychotics. This makes treatment with antipsychotics plus hormones complicated. Dose, timing and route of intervention may all prove critical to efficacy. While much remains unknown, this literature review indicates that, within standard dose ranges, the combination of hormones and antipsychotics for postnatal and menopausal women suffering severe mental distress can be beneficial, and is safe.

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“…Correlations of menopausal symptoms, hormones, and antipsychotic use are presented in Figure 2. 78–91…”

Section: Hormones and Menopausementioning

confidence: 99%

“…Discontinuation of these substances may produce withdrawal symptoms such as sweating, tremor, dizziness, headache, insomnia, rebound anxiety, tachycardia, and elevated blood pressure, which are often impossible to distinguish from true menopausal symptoms. 83,84…”

Section: Hormones and Menopausementioning

confidence: 99%

The association between hormones and antipsychotic use: a focus on postpartum and menopausal women

González-Rodríguez

Seeman

2019

Therapeutic Advances in Psychopharmacology

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Section: Review Of Literaturementioning

confidence: 99%

“…One area that has been examined in terms of how people find and maintain sobriety is the beneficial role of friends, family, and peer support (Epstein, Fischer-Elber, and Al-Otaiba 2007;Fals-Stewart, Lam, and Kelley 2009;Henderson and Gardner 1996;Rowan and Butler 2014). Epstein, Fischer-Elber, and Al-Otaiba (2007) found that formal and informal peer support groups provide needed social interactions that can reduce feelings of loneliness and can serve as sounding boards for those with substance abuse disorders to feel as if they are not in it alone. Fals-Stewart, Lam, and Kelley (2009) examined the importance of family support in maintaining abstinence.5 Emphasizing the family disease approach, these authors stated that alcoholism and drug abuse is a disease of the entire family unit, not just the individual, and therefore requires buy-in from the entire social/familial network.…”

Section: Review Of Literaturementioning

confidence: 99%

Leisure participation, substance abuse disorders, and recovery

Harmon

2017

Annals of Leisure Research

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The purpose of this paper was to explore the lived experiences of people with substance abuse disorders over the course of their lengthy participation in a music scene. When the use of drugs and alcohol either begins or is enabled in a leisure context and progresses to a state of dependency, the leisure activity often becomes secondary to the use of those substances. As will be displayed, the participants of this study maintained a high level of participation during their period of indulgence and then sustained that high level of participation after overcoming their addiction. This paper challenges a commonly held assertion that the type of leisure people with substance abuse disorders engage in is different from those of people without drug or alcohol dependencies.

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“…Furthermore, there are studies on the utilisation of emergency department care (Levy Merrick et al, 2011;Woodruff et al, 2009) and on the effects of referral to treatment, screening practices and various kinds of Unauthenticated Download Date | 3/14/17 3:21 PM early interventions (Schonfeld et al, 2014;Ettner et al, 2014;Benza, Calvert, & Mc-Quown, 2010;Kuerbis et al, 2015;Google & Owens, 2015;Wallace, Black, & Fothergill, 2010;Bakhshi & While, 2014). There are also studies that have examined the effect of gender (Epstein, Fischer-Elber, & Al-Otaiba, 2007), retirement (Wang, Steier, & Gallo, 2014;Zantinge et al, 2013) and social involvement (Dare et al, 2014) on old people's alcohol consumption.…”

Section: Introductionmentioning

confidence: 99%

How does Older People's Drinking Appear in the Daily Work of Home Care Professionals?

Koivula

Tigerstedt

Vilkko

et al. 2016

Nordic Studies on Alcohol and Drugs

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in the Helsinki metropolitan area of Finland. Everyday situations during home visits related to the clients' alcohol use were analysed according to modalities of agency of the home care professionals. RESULTS -The results focus on three themes raised in the interviews: supporting life management of the client, the lack of qualifications in tackling clients' drinking and the need for multi-professional collaboration. Intoxicated clients complicated the home care nurses' work and obstructed the implementation of recommendations set out to guide the professionals' operations. Care work with alcohol-using clients was particularly demanding, and the professionals were concerned about not having enough training in how to encounter elderly clients' drinking. Multi-professional collaboration with substance abuse services and emergency department personnel was called for to remedy this problem. CONCLUSIONS -More extensive and detailed research is needed for a better picture of how clients' drinking influences home care nurses' working conditions and what kind of skills nurses need in different alcohol-related situations. Such research would have the potential to benefit clients and improve the well-being of the employees.

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Women, Aging, and Alcohol Use Disorders

Cited by 5 publications

References 1 publication

The association between hormones and antipsychotic use: a focus on postpartum and menopausal women

The association between hormones and antipsychotic use: a focus on postpartum and menopausal women

Leisure participation, substance abuse disorders, and recovery

How does Older People's Drinking Appear in the Daily Work of Home Care Professionals?

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