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Re: Are antipsychotics neurotoxic?

Posted by NKP on August 1, 2020, at 5:17:20

In reply to Re: Are antipsychotics neurotoxic?, posted by linkadge on July 29, 2020, at 8:12:43

I've been doing some more reading on the topic (do a search for "antipsychotic brain shrinkage"). It seems that antipsychotics DO cause some loss of brain volume BUT:

(i) this is not necessarily a bad thing, e.g. pregnancy also causes a transient loss of grey matter volume;
(ii) the loss of brain volume seems not to have any clinical relevance and seems not to cause cognitive deficits;
(iii) it is not neurons as such that die, but rather, dendrites that atrophy, and synapses that shrink;
(iv) the effects appear to be reversible upon discontinuation of the medication;
(v) the effect is observable within two hours of once-off administration of intravenous haloperidol, and reverses soon after the haloperidol leaves the patient's system;
(vi) there is some evidence that, in the short run at least, the effect is more pronounced with typical antipsychotics (some studies conclude that typicals and atypicals cause the same brain shrinkage in the long run);
(vii) the effect is related to dose.

I may have my facts wrong on the above but this is the impression that I got from the literature.




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