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Limited evidence that antipsychotic drug treatment is associated with reduced brain volume

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Question

Question:

What is the impact of antipsychotic medications on brain volume and are there differences in the brain volumes of antipsychotic-naïve patients and healthy controls?

Outcomes:

Overall brain volume, grey matter volume, lobar volumes, cerebrospinal fluid (CSF) volume and subcortical ventricular spaces, measured using MRI.

Methods

Design:

Systematic review.

Data sources:

Medline searches for studies published between 1995 and April 2009.

Study selection and analysis:

To look at the effect of antipsychotic medication, longitudinal MRI studies were included that compared, at 6-month follow-up, brain-volume changes in patients with schizophrenia or psychosis and taking antipsychotics with that in healthy individuals. To look at whether there are baseline differences in brain-volume, studies looking at neuroleptic-naive patients or patients with minimal treatment (≤4 weeks) compared with healthy controls were included. Research works that focused on people from ‘high-risk’ samples, who were considered to be at high risk of psychosis due to genetic loading or subclinical symptoms, were also included.

Main results

A total of 26 longitudinal studies were identified that satisfied inclusion criteria. The studies involved a …

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