Relapse & Antipsychotic Treatment in Schizophrenia Change Brain

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Nancy Andreasen, M.D., Ph.D., University of Iowa, Expert on Schizophrenia
Nancy Andreasen, M.D., Ph.D.

Substantial evidence suggests that patients with schizophrenia have, on average, smaller volumes in several brain areas such as the frontal lobes, and that these changes progress with time. A new neuroimaging study by NARSAD Grantees Nancy Andreasen, M.D., Ph.D. and Beng-Choon Ho, M.D., of the University of Iowa in Iowa City and their team shows that the longer a period of time a patient experiences a relapse of schizophrenia symptoms and the more antipsychotics they receive, the greater their brain volume reduction.

The new study, which was published April 5, 2013 in the American Journal of Psychiatry, investigated brain tissue loss over time in subjects with schizophrenia using magnetic resonance imaging (MRI). A total of 202 subjects were scanned during their first episode of psychosis and again at regular intervals for at least five years.

The researchers found that relapse duration, defined as the total time of all relapses in the period between two brain scans, was associated with tissue loss in some brain regions. The study showed no relationship between the number of relapses and brain volume. Paradoxically, antipsychotic treatment, the best known line of defense against relapses, was also associated with lower volumes of some brain areas.

The findings suggest that extended periods of relapse, as well as treatment with antipsychotics, have a detrimental effect on the brain. The likely practical implication for patients, according to the study authors, is that relapse prevention should be achieved with the lowest antipsychotic dose possible.

Read an article on this and related studies on the Brain & Behavior Research Foundation-sponsored website Schizophrenia Research Forum

Read the study abstract in the American Journal of Psychiatry

Article comments

The study used doses of Haloperidol. Therefore, is there any reason to believe that the negative findings would also occur with atypical anti psychotics?

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