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MONDAY, Feb. 7 (HealthDay News) — The use of antipsychotic drugs to treat schizophrenia is associated with the loss of a small but measurable amount of brain tissue, a new study finds.

It included 211 schizophrenia patients who each underwent an average of three MRI brain scans over 7.2 years, for a total of 674 scans in the study group. The researchers then examined how four factors affected changes in brain volume over time: illness duration, illness severity, substance abuse and treatment with antipsychotic drugs.

Longer duration of illness and antipsychotic treatment were both associated with loss of brain tissue. Higher doses of antipsychotics were associated with overall brain tissue loss, reduced gray matter and progressive declines in white matter.

Illness severity and substance abuse had little or no association with brain tissue changes, according to the study, published in the February issue of the Archives of General Psychiatry.

Among young adults, schizophrenia is a leading cause of chronic disability, according to background information in the study. Loss of brain volume in these patients was previously thought to be caused by the illness.

While antipsychotic drugs may lead to brain tissue loss, the benefits of long-term treatment may outweigh the risks, wrote the researchers at the University of Iowa Carver College of Medicine in Iowa City.

“However, our findings point toward the importance of prescribing the lowest doses necessary to control symptoms,” they added in a news release from the journal’s publisher.

The findings also raise concerns about prescribing antipsychotic drugs for patients with mental health conditions other than schizophrenia, such as bipolar disorder or depression.

The findings shouldn’t be seem as a reason to halt the use of antipsychotic drugs to treat schizophrenia, Dr. David a. Lewis, of the University of Pittsburgh, wrote in an accompanying editorial.

“But they do highlight the need to closely monitor the benefits and adverse effects of these medications in individual patients, to prescribe the minimal amount needed to achieve the therapeutic goal, to consider the addition of non-pharmacological approaches that may improve outcomes and to continue the pursuit of new antipsychotic medications with different mechanisms of action and more favorable benefit to harm ratios,” he wrote.

– Robert Preidt

Copyright © 2011 HealthDay. All rights reserved.

SOURCE: JAMA/Archives journals, news release, Feb. 7, 2011

By Rick Nauert PhD Senior News EditorReviewed by John M. Grohol, Psy.D. on December 25, 2010

A new study suggests brain scans could be used to predict the onset of schizophrenia in young people with a family history of the disease.

University of Edinburgh researchers discovered the brains of people who later develop schizophrenia shrink at an accelerated rate before they first become ill.

Schizophrenia is a condition characterized by delusions and hallucinations that affects 1 in every 100 people – it is associated with a reduction in brain tissue but the timing of these changes has, until now, been unclear.

The study examined people at high risk of schizophrenia who had two close relatives with the disorder and were between 16 and 25 at the beginning of the study.

This is the first time that such changes in brain size have been found in people at high risk of schizophrenia before they develop any symptoms. unlike previous studies, these changes cannot be due to medication as all of the people in the study were un-medicated when they took part.

In healthy people, the brain begins to slowly shrink from early adulthood onwards.

It is known that accelerated brain shrinkage occurs in people with bipolar disorder (or manic-depression) and schizophrenia, but until now it was not known whether these changes occurred before people became unwell.

Researchers say that scans could be used to identify shrinkage of the brain in people at high risk of schizophrenia and may help doctors to diagnose the condition and start treatment at an earlier stage or even before illness first appears.

The study, published in the journal Biological Psychiatry, shows that the loss of brain tissue is concentrated in areas of the brain associated with personality, decision-making and social behavior.

Lead author Dr. Andrew McIntosh, of the Division of Psychiatry at the University of Edinburgh, said: “this study represents the culmination of more than 10-years of work and is a significant step to understanding the origins of schizophrenia years before the onset of disability and medical treatment.”

The team analyzed brain scans of 146 people with a family history of schizophrenia – but who had not yet experienced any symptoms – and compared them to scans of 36 people with no such risk.

The scans were taken every 18 months over a 10-year period.

Source: University of Edinburgh