Women and men differ in the development of drug and alcohol dependence. In alcoholism, a phenomenon called "telescoping" has been described, i.e. women usually start later with excessive alcohol intake but develop neurotoxic effects (e.g. brain atrophy) earlier than men. On the other hand, estrogens may show neuroprotective effects, which has been postulated to explain relatively preserved serotonin transporter availability in female compared with male alcoholics. Once alcohol dependence is manifest, the relapse risk seems to be higher in women compared with men. Female patients usually report more emotional distress and reduced quality of life. They also show increased comorbidity with respect to anxiety and depression, while men more often display so-called "antisocial" personality traits. Borderline personality disorder also seems to be more frequent in women and may demand specific treatment options.