Posted by linkadge on September 6, 2014, at 11:26:06
In reply to Re: Neuroleptic Brain-shrinkage, posted by Christ_empowered on September 6, 2014, at 8:19:01
Here's my take.
There probably is some effect of the disease itself. But there is also some effect from the antipsychotic.
I don't think the shrinkage is from the drug itself (I,e, olanzapine isn't directly neurotoxic), but rather the molecular effects of the drug.
For instance, using very high doses of antipsychotics are going to produce some cognitive dysfunction, reduced energy and possible glucose imbalances. Also, dopamine (in the right levels) is neurotrophic. So, blocking dopamine function excessively, probably causes certain circuits to atrophy.
In other words, the brain atrophy is probably secondary to the brain dampening effects the drugs can have. Some circuitry is being dampened. (i.e. use it or lose it).
That being said, untreated psychosis, mania, severe depression, anxiety, insomnia etc. are probably also neurotoxic.
There was a study out a few weeks back showing that chronic insomniacs display progressive brain atrophy over time.
I think at 2.5 mg you are probably pretty safe. You might try half of that just to see. In my opinion, you always want to test the lower threshold of your medication doses.
I would think that the AP's with the shorter half life would be less problematic. Also, an antidepressant *may* offset some of the negative effects of the AP. Coffee, might also offset some of the effects.
The real question (in my mind) is has the antipsychotic changed your behavior? Since starting it, are you feeling more or less engaged in life? Is your cognition better or worse? Are you exercising more or less?
Doctors often prescribe AP's for the sleep enhancing effects. You might get the same benefit from a drug like remeron, trazodone or doxepin. These drugs are more selective to the 5-ht2a receptor and *may* result in less cognitive interference.
Linakdge
poster:linkadge
thread:1070819
URL: http://www.dr-bob.org/babble/20140815/msgs/1070854.html