I have read numerous different papers each claiming that antipsychotic medication either helps maintain brain volume or causes brain volume reduction in patients with schizophrenia and other psychotic psychiatric disorders. I have to admit that I am confused on this subject. What is the clinically accepted position on brain volume and antipsychotic medication?
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$\begingroup$ Interesting question. Welcome to cogsci.SE! $\endgroup$– Nick StaunerCommented Mar 26, 2014 at 18:02
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2 Answers
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Yes, there are different results published because it is an open research question. It is a tricky question to figure out due to substantial confounding factors so some results might skew for and some against.
We know that brain volume changes due to natural reasons (age, lifestyle); different antipsychotics have different effects on different brain regions, and so does the illness and the duration of treatment. Usually, in a research study, you need to be able to control for all confounding factors to get (as much as you can) just the two variables you want: antipsychotic and brain volume. But it is challenging to do that in this case and so far, no one has been able to be conclusive about it.
Here's a systemic review of the papers that attempted to find the direction of effect and the answer is mixed results:
Psychological Medicine , Volume 40 , Issue 9 , September 2010 , pp. 1409 - 1422 DOI: https://doi.org/10.1017/S0033291709992297
and then a really nice letter in response that details some of the challenges that I mention above on why we do not know for sure (yet):
VAN HAREN NEELTJE, KAHN RENÉ. Letter to the Editor: A comment on ‘A systematic review of the effects of antipsychotic drugs on brain volume’ by Moncrieff & Leo (). Psychological Medicine. 2010;40(12):2105-2107. doi:10.1017/S0033291710001686
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Dopamine availability can increase neurogenesis/neuroplasticity in adult brains. Antipsychotic medications, therefore, may have the opposite effect.
Borta, A., & Höglinger, G. U. (2007). Dopamine and adult neurogenesis. Journal of neurochemistry, 100(3), 587–595. https://doi.org/10.1111/j.1471-4159.2006.04241.x
Nitsche, M. A., Kuo, M. F., Grosch, J., Bergner, C., Monte-Silva, K., & Paulus, W. (2009). D1-receptor impact on neuroplasticity in humans. The Journal of neuroscience : the official journal of the Society for Neuroscience, 29(8), 2648–2653. https://doi.org/10.1523/JNEUROSCI.5366-08.2009
