Propsychotic effects of the treatment with androgens in gender dysphoric women: A case presentation

According to International Classification of Diseases ICD-10, the diagnosis of transsexualism requires the exclusion of severe mental disorders (e.g., psychotic disorders). The majority of the psychotic patients presenting the... [ view full abstract ]

According to International Classification of Diseases ICD-10, the diagnosis of transsexualism requires the exclusion of severe mental disorders (e.g., psychotic disorders). The majority of the psychotic patients presenting the coexisting gender dysphoric symptoms are not diagnosed with gender dysphoria but rather as being delusional with respect to their gender identity. The World Professional Association for Transgender Health suggests that psychotropic medication for severe mental disorders should be optimally managed prior to or concurrent with treatment of gender dysphoria. According to the WPATH standards of care, psychotropic medications facilitate both the resolution of gender dysphoria, and the making of informed decisions about medical interventions towards possible changes in gender role.

A case presentation. [ view full abstract ]

A case presentation.

The case presentation is dedicated to the analysis of the determinants of treatment of a 28-years old female patient treated for paranoid schizophrenia and gender dysphoria. The literature describes only a few cases concerning... [ view full abstract ]

The case presentation is dedicated to the analysis of the determinants of treatment of a 28-years old female patient treated for paranoid schizophrenia and gender dysphoria. The literature describes only a few cases concerning the hormonal treatment of transgender people suffering from psychotic disorders. The treatment of gender dysphoria with comorbid psychotic features still raises a lot of controversy. The psychoneuroendocrinological determinants of treatment of gender dysphoria and comorbid psychotic symptoms are discussed in the light of the primary hypogonadism and primary hyperprolactinemia in schizophrenia. The discussion also covers the topics of the sex steroids augmentation of antipsychotic treatment in schizophrenia.

A number of questions raise concerning the safety and effectiveness of the sex hormones used in this group of patients due to the CNS effect of both estradiol and testosterone. Particular difficulties are associated with the... [ view full abstract ]

A number of questions raise concerning the safety and effectiveness of the sex hormones used in this group of patients due to the CNS effect of both estradiol and testosterone. Particular difficulties are associated with the treatment with androgens due to their pro-psychotic effects.