Selecting the right treatment plan for schizophrenia in postmenopausal women: an update of the literature.

INTRODUCTION: The transition from reproductive to menopausal status constitutes amajor rite of passage for women, biologically, psychologically, and socially. For women with adiagnosis of schizophrenia, this stage of life is complicated by worsening psychotic symptoms and diminished effectiveness of antipsychotic drugs. This frequently leads to increased doses and subsequently increased adverse effects.

AREAS COVERED: The aim of this narrative review is to determine what management changes are needed at this time of life for women with schizophrenia. Searched and highlighted are the areas of sleep, cognition, occupation/employment, psychotic symptoms, side effects of treatment, and non-psychiatric as well as psychiatric co-morbidities which, when not adequately treated, can undermine quality of life and lead to premature death.

EXPERT OPINION: Many of the problems associated with menopause in women with schizophrenia can be prevented or remediated. Nevertheless, more research addressing the changes that occur in women with schizophrenia from pre- to post-menopause will help to bring clinical attention to this important health issue.