Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Re: Neuroleptic Brain-shrinkage

Posted by SLS on September 6, 2014, at 12:13:49

In reply to Re: Neuroleptic Brain-shrinkage, posted by Christ_empowered on September 6, 2014, at 8:19:01

Tissue loss is often seen in the first-episode of schizophrenia before drugs are introduced (drug-naive). It is difficult to determine whether the tissue loss seen in neuroleptic-treated cases is the result of drug exposure or a natural progression of the disease. There is much debate on this issue. However, it is difficult to ignore the reports of larger decreases in brain tissue following treatment with the older first-generation typical antipsychotics than with the newer atypical drugs. One could argue that this is an artifact of illness severity, but I found this:

- Scott


Antipsychotic drug effects on brain morphology in
first-episode psychosis

Year: 2005
Source title: Archives of General Psychiatry
Volume: 62
Issue: 4
Page : 361-370


Background: Pathomorphologic brain changes occurring as early as first-episode schizophrenia
have been extensively described. Longitudinal studies have demonstrated that these changes may be
progressive and associated with clinical outcome. This raises the possibility that antipsychotics might alter
such pathomorphologic progression in early-stage schizophrenia.

Objective: To test a priori hypotheses that
olanzapine-treated patients have less change over time in whole brain gray matter volumes and lateral
ventricle volumes than haloperidol-treated patients and that gray matter and lateral ventricle volume changes
are associated with changes in psychopathology and neurocognition.

Design: Longitudinal, randomized,
controlled, multisite, double-blind study. Patients treated and followed up for up to 104 weeks.
Neurocognitive and magnetic resonance imaging (MRI) assessments performed at weeks 0 (baseline), 12,
24, 52, and 104. Mixed-models analyses with time-dependent covariates evaluated treatment effects on MRI
end points and explored relationships between MRI, psychopathologic, and neurocognitive outcomes.
Setting: Fourteen academic medical centers (United States, 11; Canada, 1; Netherlands, 1; England, 1).
Participants: Patients with first-episode psychosis (DSM-IV) and healthy volunteers. Interventions: Random
allocation to a conventional antipsychotic, haloperidol (2-20 mg/d), or an atypical antipsychotic, olanzapine
(5-20 mg/d). Main Outcome Measures: Brain volume changes assessed by MRI.

Results: Of 263 randomized patients, 161 had baseline and at least 1 postbaseline MRI evaluation. Haloperidol-treated
patients exhibited significant decreases in gray matter volume, whereas olanzapine-treated patients did not.
A matched sample of healthy volunteers (n=58) examined contemporaneously showed no change in gray
matter volume.

Conclusions: Patients with first-episode psychosis exhibited a significant between-treatment
difference in MRI volume changes. Haloperidol was associated with significant reductions in gray matter
volume, whereas olanzapine was not. Post hoc analyses suggested that treatment effects on brain volume
and psychopathology of schizophrenia may be associated. The differential treatment effects on brain
morphology could be due to haloperidol-associated toxicity or greater therapeutic effects of olanzapine.

Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw




Post a new follow-up

Your message only Include above post

Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.


Start a new thread

Google www
Search options and examples
[amazon] for

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:SLS thread:1070819