Estradiol administration to a treatment-resistant man with schizophrenia

An 18-year old man suffering from catatonic schizophrenia was unsuccessfully treated with several antipsychotic regimen and refused electroconvulsive therapy after nine sessions with limited improvement. Because of this multiple drug resistance and reports of estradiol to constitute a protective factor in schizophrenia, gonadal function was investigated revealing low estradiol levels. A therapeutic trial with estradiol was started additionally to a raise in clozapine dosage. Two weeks thereafter a marked improvement was noticeable. It is discussed whether estradiol administration might have been necessary to facilitate clinical improvement.