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Concerns about the side effects of antipsychotic drugs used to treat schizophrenia are growing, as a recent study shows that they may lead to loss of brain tissue. Do antipsychotic drugs shrink the brain?

Chronic disability due to schizophrenia is a common problem among young adults. This mental illness affects about one percent of the population, and treatment often involves the use of antipsychotic medications, which help reduce schizophrenia symptoms and improve their mental and social functioning. 

However, recent studies suggest that antipsychotics may lead to loss of brain tissue, leading concerned doctors and patients to wonder if these drugs could “shrink” the brain.

Antipsychotic Drugs for Schizophrenia

Schizophrenia is a severe, chronic, disabling mental disorder that affects many young adults. It manifests with symptoms related to bizarre thought processes, impaired mental functioning, and inability to interact or take care of themselves.

Schizophrenia includes symptoms such as hallucinations, delusions, violent outbursts, and substance abuse, which often pose difficult challenges to the patients’ families and the society. Approximately one percent of the American population is affected by this mental disorder, and its burden to society is related to problems in employment, relationships, and personal independence. Aside from these, schizophrenics are also prone to substance abuse, obesity, and other medical problems related to their inability to care for themselves.

The mainstay of treatment for schizophrenia is the use of antipsychotic medications, which may be classified as typical and atypical antipsychotics.

These include:

Typical Antipsychotic Drugs:

  • Haloperidol (Haldol)
  • Chlorpromazine (Thorazine)
  • Perphenazine (Trilafon, Etrafon)
  • Fluphenazine (Prolixin)

Atypical Antipsychotic Drugs:

  • Risperidone (Risperdal)
  • Clozapine (Clozaril)
  • Olanzapine (Zyprexa)
  • Paliperidone (Invega)
  • Ziprasidone (Geodon)
  • Quetiapine (Seroquel)
  • Aripiprazole (Abilify)

These medications reduce the positive symptoms of schizophrenia, which consist of hallucinations, delusions and disorganized behavior and speech. They also help reduce violent or aggressive behavior, suicidal tendencies, and help prevent relapses and hospital re-admission.

Antipsychotic drugs are often given for long-term use and they are believed to improve the quality of life of patients, increase their independence, and enhance their productivity.

However, just like any drug, antipsychotic medications have side effects.

Common Side Effects of Antipsychotic Drugs

Typical antipsychotic medications work by blocking so-called dopaminergic receptors, which influence the appearance of symptoms typical of schizophrenia. However, they may also affect other neurotransmitter systems, which lead to undesirable side effects.

Common side effects associated with typical antipsychotics include movement disorders such as tremors, restlessness, and rigidity. Unusual, uncontrollable movements of the body, such as lip-smacking and jerky head movements are severe manifestations of movement problems associated with antipsychotics. Other side effects include dry mouth, problems in urination, constipation, visual disturbances, dizziness, nasal congestion, and disturbances of sexual function.

Atypical antipsychotics have less of these side effects, but they have been associated with weight gain and increased risk for developing blood abnormalities, diabetes, cataracts, high blood lipid levels, irregular heart rhythms, and heart disease (myocarditis).

In addition, antipsychotics may alter hormonal function, leading to cessation of menstruation, spontaneous production of breast milk, and enlargement of male breasts.

Aside from these, recent studies suggest alarming observations that antipsychotic drugs may reduce brain volume and cause a subtle loss of brain tissue.
Continue reading after recommendations

  • B.-C. Ho, N. C. Andreasen, S. Ziebell, R. Pierson, V. Magnotta. Long-term Antipsychotic Treatment and Brain Volumes: A Longitudinal Study of First-Episode Schizophrenia. Archives of General Psychiatry, 2011
  • 68 (2): 128 DOI: 10.1001/archgenpsychiatry.2010.199
  • Nauert, R. Loss of Brain Tissue in Schizophrenia Tied to Antipsychotics. PsychCentral. WebMD. Therapy for Schizophrenia.
  • Beaumont, G. Antipsychotics - The Future of Schizophrenia Treatment. Curr Med Res Opin. 2000
  • 16(1) Schizophrenia Drugs May Spur Subtle Brain Tissue Loss.
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