Dr. Riddle is a psychiatry resident, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington. Dr. Buchholz is an attending psychiatrist, VA Puget Sound Healthcare System, and Assistant Professor, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
Disclosures The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
Ms. A, age 51, has schizophrenia that for years had been stabilized with haloperidol. She recently became agitated and refuses to take medication. What could be causing these changes?
Bottom Line
The menopausal transition is a time of increased risk for women with schizophrenia. For peri- and postmenopausal women with schizophrenia, a selective estrogen receptor modulator, such as raloxifene, may be considered as an adjunctive therapy. Evaluate the risks and benefits of raloxifene, particularly the increased risk of thromboembolism, before starting this medication.