Do Antipsychotic Drugs Lead To Loss Of Brain Tissue?

Loss of brain tissue is one characteristic believed to be associated with schizophrenia, along with other structural and chemical changes in the brain. 

Effects on Brain Tissue

Although antipsychotic drug treatments have led to significant reduction of the targeted symptoms of psychosis in schizophrenics, experts are now concerned whether they could also negatively affect brain volumes and function. Previous animal studies showed that long-term treatment with these drugs led to smaller brains in monkeys.

To investigate their effects on human brains, scientists from the University of Iowa Carver College of Medicine, Iowa City, studied more than 200 schizophrenic patients whose brains were repeatedly subjected to magnetic resonance imaging (MRI) scans after the onset of illness and over a period of about seven years of treatment with antipsychotics.

The authors wanted to evaluate the effects of four potential predictors of brain volume change in their schizophrenic patients, including the illness duration, severity of illness, substance abuse, and antipsychotic treatment.

They found that treatment with the drugs was associated with significant measurable brain tissue reductions after controlling for other predictors. 

They also noted that typical antipsychotics like haloperidol were more likely to be associated with smaller brains than were atypical antipsychotics such as olanzapine.

Although their findings support previous studies, the scientists point out that no cause-and-effect relationship has been established between antipsychotic drug therapy and loss of brain tissue. Further studies have to be done to find out if drug treatment can cause deleterious effects on the brain in people being treated for schizophrenia.

Recommendations

Antipsychotics drugs are the first line of treatment for schizophrenia. They reduce frightening symptoms such as hallucinations and aggressive behaviors and can reduce one’s risk for relapse or suicide. However, these drugs are associated with many undesirable side effects.

Although recent studies may suggest that progressive brain tissue loss may be related to intense antipsychotic therapy, experts believe that the benefits of using these drugs outweigh their harmful side effects. They assert that there is no reason why antipsychotic therapy must be withdrawn if they are making patients feel better, work better, and live more fully.

The authors, however, emphasize the need to monitor more closely the benefits and harmful effects of these antipsychotic medications in individual patients. They recommend prescribing minimal doses needed to achieve therapeutic goals for each patient and to consider adding non-pharmacological methods of treatment.  

These include individual psychotherapy, family counseling, vocational counseling, and social skills training, which could help improve treatment outcomes while helping to reduce the need for medications.