To continue or not to continue?
To continue or not to continue?
Nearly half of all people in the Netherlands will experience a psychiatric disorder at some point in their lives. So how can we ensure that treatment truly fits the unique person?
This dissertation of Franciska de Beer shows that mental disorders develop differently in women than in men. Women have different vulnerable periods, such as around their thirties and in their fifties. Hormonal phases, including the menopausal transition, also play a major role. They influence not only when symptoms arise, but also how well medications such as antidepressants and antipsychotics work.
Yet there are no female-specific clinical guidelines for these medications. As a result, women often receive the same dose as men. This dissertation shows that women have higher blood levels of many antidepressants and several antipsychotics. This can make the medication more effective, but also increases the likelihood of side effects. During menopause, blood levels change again, raising the risk of relapse into depression or psychosis.
For people recovering from a first episode of psychosis, it is often assumed that all antipsychotics are roughly equally effective and that finding the right dose is what matters. This research demonstrates otherwise: the type of antipsychotic is also important for recovery. Drugs that strongly inhibit dopamine increase the risk of relapse, whereas medications that inhibit the dopamine system more mildly are linked to fewer problems with cognition, emotions, and daily functioning. Findings from the world’s largest antipsychotic tapering study show that tapering earlier has short-term risks, but may lead to better functioning in the long run.