Psychosis, Antipsychotics, and Estrogen
Chlorpromazine was the first antipsychotic available. It was originally designed to ease patients going into surgery. (4)
Antipsychotics counter the symptoms of auditory and visual hallucinations, delusional thoughts, and incoherent speech. This is accomplished by blocking dopamine D2 receptors, especially those in a state of “high affinity for dopamine.” (5)
The high-affinity state is clinically relevant because it controls symptoms, such as hallucinations and delusions, and is responsible for side effects such as hyperprolactinemia. (6)
Dopamine receptor blockade, caused by the use of antipsychotics, raises prolactin levels which, in turn, lowers gonadal steroid and makes conception difficult. However, antipsychotics can be stopped during pregnancy, because of rising estrogen levels. Estrogen modulation of the dopamine receptor provides relative protection against a psychotic relapse. (6)
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