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Antipsychotics and brain volume

Posted by NKP on December 3, 2022, at 4:39:47

Numerous studies seem to indicate that antipsychotic use results in a reduction in brain volume. I'm not sure what to make of this.

I saw a study that found a small but significant reduction in brain volume within hours of taking a once-off dose of haloperidol, with brain volume later returning to baseline. I suspect that this short-term reduction in brain volume is due to a reduction in blood flow to the brain, rather than a loss of neurons.

The concern is what happens if you take antipsychotics long term. Could chronically reduced blood flow result in permanent atrophy in the long run? Does this impact intelligence?

Apparently loss of brain volume in schizophrenics who do *not* take antipsychotic medication, is greater than in schizophrenics who *do* take antipsychotic medication. If antipsychotics are neurotoxic, as some claim, then they seem not to do a very good job of being neurotoxic in schizophremics at least.

Questions:

(i) What are your thought on the matter of brain volume loss caused by antipsychotics?
(ii) Is this also an issue with low dose antipsychotics as used to treat depression?
(iii) What about drugs like flupentixol and aripiprazole? As I understand it, these increase dopaminergic signalling at low doses, doing roughly the opposite of an antipsychotic. Would this also result in a reduction of brain volume?


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poster:NKP thread:1121182
URL: http://www.dr-bob.org/babble/20220917/msgs/1121182.html