phytoestrogens and Venous-Thromboembolism

Reduced estrogen levels at menopause mean a loss of the neuroprotection that is conferred, from puberty until menopause, on women with schizophrenia. The postmenopausal stage of schizophrenia requires therapeutic attention because women with this diagnosis almost invariably experience increased symptoms and increased side effects at this time. So far, few targeted therapies have been successfully developed.. This non-systematic, narrative review is based on the relevant published literature indexed in PubMed. A digital search was combined with a manual check of references from studies in the field of gender differences, menopause and schizophrenia. Aside from the inclusion of a few early classic papers, the review focuses on 21st century basic, psychopharmacologic, and clinical literature on the treatment of women with schizophrenia after menopause.. Beyond a relatively low dose threshold, all antipsychotic medications have adverse effects, which become more prominent for women at the time of menopause. Estrogen modulators may not help all symptoms of schizophrenia but are, nevertheless, relatively safe and, when used as adjuncts, help to keep antipsychotic doses low, thus reducing the side effect burden. The field is currently moving towards precision medicine and individual genetic profiles will help to determine the efficacy of available treatments in the future.

Topics: Antipsychotic Agents; Female; Humans; Phytoestrogens; Postmenopause; Raloxifene Hydrochloride; Receptors, Estrogen; Schizophrenia; Venous Thromboembolism

To create physician awareness of complementary and alternative medicine therapy use in patients with prostate cancer so that physicians can monitor for adverse events. Approximately one fourth to one third of patients diagnosed with prostate cancer reported complementary and alternative medicine use, and many of these patients are taking a supplement called "Dr. Donsbach's Prostasol.". We discuss the cases of 2 patients with prostate cancer who were taking Dr. Donsbach's Prostasol and developed venous thromboembolic events while taking this supplement, in the absence of other obvious risk factors. We review these 2 cases and the time-line for the development of the venous thromboembolic events and use of Dr. Donsbach's Prostasol. We compared Prostasol with PC-SPES, a similar supplement that was associated with thrombosis and was ultimately taken off the market because of patient safety concerns.. Prostasol contains phytoestrogens that could result in both the suppression of testosterone and the predisposition to thrombosis. Both patients had suppression of their testosterone to castrate levels with an associated decrease in prostate-specific antigen at the time of their thrombotic event.. These cases are suggestive of an association between Prostasol use and venous thromboembolic events. Physicians should be aware of the use of this agent in their patients, although it is not known whether it would be appropriate to prescribe prophylactic low-dose warfarin therapy. If possible, additional study of complementary and alternative medicine therapies for safety and efficacy are indicated.

Topics: Aged; Aged, 80 and over; Complementary Therapies; Dietary Supplements; Drugs, Chinese Herbal; Enoxaparin; Humans; Male; Medical Oncology; Phytoestrogens; Plant Preparations; Prostatic Neoplasms; Venous Thromboembolism; Venous Thrombosis; Warfarin