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Schizophrenia Bulletin Advance Access published online on April 9, 2008
Schizophrenia Bulletin, doi:10.1093/schbul/sbn023
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© The Author 2008. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Secondary Effects of Antipsychotics: Women at Greater Risk Than Men

Mary V. Seeman1,2
2 Professor Emerita, Department of Psychiatry, University of Toronto

1 To whom correspondence should be addressed; tel: 416-979-4671, fax: 416-978-1053, e-mail: mary.seeman{at}utoronto.ca.

Context: The health burden of antipsychotic medication is well known, but the disproportionate effect on women as compared with men is underappreciated. Objective: The goal of this article is preventive—to better inform clinicians so that the risks to women and to their offspring can be diminished. Method: All PubMed sources in which the search term gender (or sex) was linked to a side effect of antipsychotic medication were reviewed. Result: There is general agreement in the literature on women's increased susceptibility to weight gain, diabetes, and specific cardiovascular risks of antipsychotics, with less consensus on malignancy risks and risks to the fetus. Cardiovascular death, to which men are more susceptible than women, is disproportionately increased in women by the use of antipsychotics. Sedating antipsychotics raise the risk of embolic phenomena during pregnancy, and postpartum. Prolactin-elevating drugs suppress gonadal hormone secretion and may enhance autoimmune proclivity. Conclusions: Clinicians need to be aware of the differential harm that women (and their offspring) can incur from the side effects of antipsychotics.

Keywords: antipsychotics side effects / women / cardiovascular risk / autoimmunity / thromboembolism / malignancy / blood dyscrasia


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