Does Gender Play A Role In The Use Of Mental Health Medication?

We now know that there are differences between how men and women respond to medication of all types, including the medications used to treat mental illness. Unfortunately, we only learned this very recently – at least in the US, women were not allowed to take part in clinical trials until the past few decades. At the same time, women are nearly twice as likely to have psychotropic medications prescribed to them than are their male counterparts and for a variety of factors, these patients may be more sensitive to these medications. Unfortunately, this also extends to side effects, which women are as much as 75% more likely to experience than men. So, what are the possible differences in mental health medication between men and women?

It was only in the last year that the US FDA finally released gender-specific dosage guidelines for certain medications, but it’s clear that there is a serious problem with the way that medications are prescribed – and many would say, overprescribed, to women.

Antidepressant Medications

Women tend not to respond to tricyclic antidepressant medications as well as men do, but have a better response to SSRI antidepressants than men. Women tend to have less stomach acid than men, which is thought to lead to a quicker absorption of SSRIs, which may be partially responsible for their greater effect in women, but can also pose a higher risk of toxicity than in male patients.

Opiates and Other Potentially Addictive Pain Medication

It’s been found that estrogen can modulate the pain response in women, resulting in women experiencing a heightened level of pain relief from opiates. While men are more likely to overdose on these medications than are women, women tend to experience a much harder time getting off of these medications and have more frequent relapses – and this cycle of addiction can lead to other mental health issues.

Antianxiety Medications

Similarly to SSRIs, many antianxiety medications are absorbed more quickly and have a more potent effect on women – unfortunately, also with a higher risk of toxicity, even at what is considered to be a standard dose. Women also may need a longer interval in between doses, since women’s kidneys tend to take slightly longer to eliminate many drugs than men’s kidneys.

Antipsychotic Medications

Haloperidol and other common antipsychotic medications tend to be more effective in treating delusions, hallucinations and other symptoms of psychosis in women than men, even at lower dosages.

Gender Bias In Clinical Testing, Diagnosis, And Treatment

The real issues seem to be a lack of study and a bias towards medicating women’s symptoms, despite the fact that many psychotropic medications have been tested very little or not at all on women. This can lead to a serious risk of dangerous side effects in female patients – and there is also evidence that women are more frequently prescribed medication than are male patients with the same complaints. While things are starting to move in the right direction with the FDA working to include women in clinical trials and account for gender differences, much work remains to be done to ensure not only that medications are safe and effective for women as well as men and that mental health professionals don’t over prescribe in response to the symptoms of their female patients.

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Latest update: October 11, 2016
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